Tateishi Ukihide, Hasegawa Tadashi, Beppu Yasuo, Kawai Akira, Satake Mitsuo, Moriyama Noriyuki
Division of Diagnostic Radiology, National Cancer Center Hospital and Research Institute, Tsukiji, Chuo-Ku, Tokyo 104-0045, Japan.
AJR Am J Roentgenol. 2004 Mar;182(3):725-31. doi: 10.2214/ajr.182.3.1820725.
The aims of this study were to determine the prognostic significance of MRI findings in patients with myxoid-round cell liposarcomas and to clarify which MRI features best indicate tumors with adverse clinical behavior.
The initial MRI studies of 36 pathologically confirmed myxoid-round cell liposarcomas were retrospectively reviewed, and observations from this review were correlated with the histopathologic features. MR images were evaluated by two radiologists with agreement by consensus, and both univariate and multivariate analyses were conducted to evaluate survival with a median clinical follow-up of 33 months (range, 9-276 months).
Statistically significant MRI findings that favored a diagnosis of intermediate- or high-grade tumor were large tumor size (> 10 cm), deeply situated tumor, tumor possessing irregular contours, absence of lobulation, absence of thin septa, presence of thick septa, absence of tumor capsule, high-intensity signal pattern, pronounced enhancement, and globular or nodular enhancement. Of these MRI findings, thin septa (p < 0.05), a tumor capsule (p < 0.01), and pronounced enhancement (p < 0.01) were associated significantly, according to univariate analysis, with overall survival. Multivariate analysis indicated that pronounced enhancement was associated significantly with overall survival (p < 0.05).
Contrast-enhanced MRI findings can indicate a good or adverse prognosis in patients with myxoid-round cell liposarcomas.
本研究旨在确定黏液样-圆形细胞脂肪肉瘤患者MRI表现的预后意义，并阐明哪些MRI特征最能提示具有不良临床行为的肿瘤。
回顾性分析36例经病理证实的黏液样-圆形细胞脂肪肉瘤的初始MRI研究，并将该回顾中的观察结果与组织病理学特征相关联。由两名放射科医生对MR图像进行评估并达成共识，进行单因素和多因素分析以评估生存情况，临床中位随访时间为33个月（范围9 - 276个月）。
在统计学上支持诊断为中级或高级别肿瘤的显著MRI表现为肿瘤体积大（> 10 cm）、肿瘤位置深、肿瘤轮廓不规则、无分叶、无薄分隔、有厚分隔、无肿瘤包膜、高信号模式、明显强化以及球形或结节状强化。在这些MRI表现中，根据单因素分析，薄分隔（p < 0.05）、肿瘤包膜（p < 0.01）和明显强化（p < 0.01）与总生存显著相关。多因素分析表明，明显强化与总生存显著相关（p < 0.05）。
对比增强MRI表现可提示黏液样-圆形细胞脂肪肉瘤患者的预后良好或不良。
