Barentsz J O, Engelbrecht M, Jager G J, Witjes J A, de LaRosette J, van Der Sanden B P, Huisman H J, Heerschap A
Department of Radiology, University Hospital, Nijmegen, The Netherlands.
J Magn Reson Imaging. 1999 Sep;10(3):295-304. doi: 10.1002/(sici)1522-2586(199909)10:3<295::aid-jmri10>3.0.co;2-z.
Among the noninvasive imaging modalities, contrast enhanced magnetic resonance (MR) imaging is the most powerful tool with which to visualize vascularity. Common pathology only shows microvessel density, whereas dynamic MR imaging is sensitive to the total endothelial surface area of perfused vessels. Therefore, dynamic MR imaging may be of additional value in tumor staging and in evaluating therapies that affect the perfused microvessel density or surface area, such as chemo-, radiation, or anti-angiogenic therapy. In urinary bladder cancer, this technique results in improved local and nodal staging, in improved separation of transurethral granulation tissue and edema from malignant tumor, and in improved evaluation of the effect of chemotherapy. In prostate cancer, dynamic MR imaging may be of help in problematic cases. This technique can assist in determining seminal vesicle infiltration, in depicting of minimal capsular penetration, and in recognizing tumors within the transitional zone. Also, based on very rapid enhancement, very poorly differentiated tumors can be recognized. Evaluation of the effects of therapy is another promising area, however a lot of research remain to be done. This article reviews some basics of fast enhancement techniques, provides practical information, and shows recent developments, in using these fast techniques for staging and grading of bladder and prostate cancer, and for evaluating the effect of therapy.
在非侵入性成像方式中，对比增强磁共振（MR）成像 是可视化血管的最强大工具。常见病理仅显示微血管密度，而动态MR成像对灌注血管的总内皮表面积敏感。因此，动态MR成像在肿瘤分期以及评估影响灌注微血管密度或表面积的治疗方法（如化疗、放疗或抗血管生成治疗）方面可能具有额外价值。在膀胱癌中，该技术可改善局部和淋巴结分期，更好地区分经尿道肉芽组织和水肿与恶性肿瘤，以及更好地评估化疗效果。在前列腺癌中，动态MR成像在疑难病例中可能会有所帮助。该技术可协助确定精囊浸润、描绘最小包膜穿透情况以及识别移行区内的肿瘤。此外，基于非常快速的强化，可识别出分化极差的肿瘤。评估治疗效果是另一个有前景的领域，然而仍有许多研究有待开展。本文回顾了快速强化技术的一些基础知识，提供了实用信息，并展示了在使用这些快速技术进行膀胱癌和前列腺癌的分期、分级以及评估治疗效果方面的最新进展。
