Engelhard K, Hollenbach H P, Wohlfart K, von Imhoff E, Fellner F A
Department of Radiological Diagnostics, Martha-Maria Hospital, Stadenstrasse 58, 90491, Nürnberg, Germany. k.engelhard @martha-maria.de
Eur Radiol. 2004 Jan;14(1):99-105. doi: 10.1007/s00330-003-1968-7. Epub 2003 Jul 5.
The aim of this study was presentation of a whole-body MRI technique with a moving table as a screening tool for bone metastases in patients with breast cancer. Twenty-two patients with breast carcinoma underwent both a planar whole-body bone scintigraphy and whole-body MRI at 1.5 T. The MRI images were acquired with a moving table at six different anatomical positions within a measurement time of 20 min. Coronal images were acquired using a short-tau inversion recovery sequence, accomplished by an axial T2-weighted turbo-spin-echo sequence through the head, and a T1-weighted opposed-phase sagittal 2D fast low-angle shot sequence covering the whole spine. The MRI findings indicating bone metastases were compared with findings from bone scintigraphy. Metastatic lesions were confirmed by follow-up examinations over 1 year. Twelve patients showed bone metastases. Whole-body MRI was superior to bone scintigraphy in predicting lesion origin with a sensitivity of 92% (bone scintigraphy 83%), a specificity of 90% (scintigraphy 80%) and an accuracy of 91% (scintigraphy 82%). The MRI showed additional findings such as metastases of the lung and liver. Whole-body MRI with moving table technique may be an effective method of total body screening for bone in selected patients with breast carcinoma and a high risk of distant metastases, although with the higher costs of MRI bone scintigraphy must still be considered as the first method for screening patients with breast cancer.
本研究的目的是介绍一种以移动检查床为基础的全身MRI技术，作为乳腺癌患者骨转移的筛查工具。22例乳腺癌患者同时接受了平面全身骨闪烁显像和1.5T的全身MRI检查。MRI图像通过移动检查床在6个不同解剖位置采集，采集时间为20分钟。采用短反转时间反转恢复序列采集冠状位图像，通过头部的轴向T2加权涡轮自旋回波序列以及覆盖整个脊柱的T1加权反相位矢状面二维快速低角度激发序列完成。将MRI提示骨转移的结果与骨闪烁显像的结果进行比较。通过1年以上的随访检查证实转移病灶。12例患者显示有骨转移。全身MRI在预测病灶起源方面优于骨闪烁显像，其敏感性为92%（骨闪烁显像为83%），特异性为90%（骨闪烁显像为80%），准确性为91%（骨闪烁显像为82%）。MRI还显示了其他发现，如肺和肝转移。对于有远处转移高风险的特定乳腺癌患者，移动检查床技术的全身MRI可能是一种有效的全身骨筛查方法，尽管由于MRI成本较高，骨闪烁显像仍必须被视为乳腺癌患者筛查的首选方法。
