Bader T R, Semelka R C, Chiu V C, Armao D M, Woosley J T
Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7510, USA.
J Magn Reson Imaging. 2001 Sep;14(3):261-9. doi: 10.1002/jmri.1182.
The purpose of this study was to evaluate the spectrum of appearances of gastrointestinal carcinoid tumors at magnetic resonance imaging (MRI) and to elucidate patterns of appearances of carcinoid liver metastases on precontrast and postgadolinium images. The MR examinations of 29 patients (11 men, 18 women; age range, 33-87 years) with histologically confirmed gastrointestinal carcinoid tumors, representing our complete 9.5 years of experience with this entity, were retrospectively reviewed. Twelve patients had MR examinations prior to resection or biopsy of the primary tumor (preoperative group); 17 patients were imaged postsurgically (postoperative group). All MR studies were performed at 1.5 T and comprised T1-weighted spoiled gradient echo (SGE), T2-weighted fat-suppressed turbo spin echo, HASTE, and serial postgadolinium T1-weighted SGE sequences without and with fat suppression. Morphology, signal intensity, and contrast enhancement of primary tumors and of metastases to the mesentery, peritoneum, and liver were evaluated. Primary tumors were visualized in 8 of 12 patients and best demonstrated on postgadolinium T1-weighted fat-suppressed images. The appearance of primary tumors was a nodular mass originating from the bowel wall (4 of 12 patients) or regional uniform bowel wall thickening (4 of 12 patients) with moderate intense enhancement on postgadolinium images. In 4 of 12 patients the primary tumor was prospectively not seen. Mesenteric metastases, seen in eight patients, presented as nodular masses and were associated with mesenteric stranding in seven patients. A total of 156 liver metastases were evaluated in 16 patients. On precontrast T1- and T2-weighted images, 117 metastases (75%) were hypointense and hyperintense, respectively. A total of 146 metastases (94%) were hypervascular, showing moderate intense enhancement during the hepatic arterial phase, and 9 metastases (6%) were hypovascular. Twenty-three metastases (15%) were visible only on immediate postgadolinium images. MRI is able to demonstrate findings in carcinoid tumors, including the primary tumor, mesenteric metastases, and liver metastases. Liver metastases are commonly hypervascular and may be demonstrable only on immediate postgadolinium images.
本研究的目的是评估胃肠道类癌肿瘤在磁共振成像（MRI）中的表现谱，并阐明类癌肝转移瘤在增强前和增强后图像上的表现模式。对29例经组织学证实为胃肠道类癌肿瘤患者（11例男性，18例女性；年龄范围33 - 87岁）的MR检查进行回顾性分析，这些病例代表了我们9.5年来对该疾病的全部经验。12例患者在原发性肿瘤切除或活检前进行了MR检查（术前组）；17例患者在手术后进行了成像（术后组）。所有MR研究均在1.5T下进行，包括T1加权扰相梯度回波（SGE）、T2加权脂肪抑制快速自旋回波、HASTE以及增强前后的T1加权SGE序列（有无脂肪抑制）。评估原发性肿瘤以及肠系膜、腹膜和肝脏转移瘤的形态、信号强度和对比增强情况。12例患者中有8例可见原发性肿瘤，在增强后T1加权脂肪抑制图像上显示最佳。原发性肿瘤的表现为起源于肠壁的结节状肿块（12例患者中的4例）或局部肠壁均匀增厚（12例患者中的4例），在增强后图像上有中等强度强化。12例患者中有4例原发性肿瘤未被发现。8例患者出现肠系膜转移，表现为结节状肿块，7例患者伴有肠系膜条索状改变。16例患者共评估了156个肝转移瘤。在增强前T1加权和T2加权图像上，分别有117个转移瘤（75%）呈低信号和高信号。共有146个转移瘤（94%）为富血管性，在肝动脉期显示中等强度强化，9个转移瘤（6%）为乏血管性。23个转移瘤（15%）仅在增强后即刻图像上可见。MRI能够显示类癌肿瘤的表现，包括原发性肿瘤、肠系膜转移和肝转移。肝转移瘤通常为富血管性，可能仅在增强后即刻图像上显示。
