Vidiri A, Carpanese L, Annibale M D, Caterino M, Cosimelli M, Zeuli M, David V, Crecco M
Radiology, Abdominal Surgery, Regina Elena Institute, La Sapienza University, Rome, Italy.
J Exp Clin Cancer Res. 2004 Mar;23(1):53-60.
The purpose of this study was to compare the results obtained with superparamagnetic iron oxide-enhanced and unenhanced Magnetic Resonance at 1.5 T with that of spiral-computed tomography (CT) in order to select those patients suitable for liver resection; the intraoperative US (IOUS) comprised the gold standard. Thirty five candidates for liver resection with known colorectal neoplasm were studied; 26 patients underwent surgery, one patient underwent RF ablation and 8 of them were submitted to follow-up. MR examination was performed using a 1.5 T superconductive instrument, CT examination was performed on a Somatom-Plus (Siemens) scanner. Dimensions and number of the lesions were defined in all patients as well as the sensitivity of spiral CT and MR imaging, using either the plain technique or after Ferumoxides c.m.. In those patients submitted to surgery, results have been correlated to those of IOUS. From 26 patients, a total of 48 lesions were removed surgically. With CT, 34 lesions with 3 false positive cases were detected; 32 with plain MR imaging, while MR imaging with Ferumoxides detected 41 lesions. In the patients not submitted to surgery, MR iron-oxide imaging identified 15 lesions, while both plain MR imaging and CT showed 8 lesions. The smallest lesion was 6 mm. as shown by MR imaging with Ferumoxides. In the cases submitted to surgery, the CT sensitivity was 71%, plain MR imaging 66% and MR imaging with Ferumoxides 85%. In our experience, Ferumoxides-enhanced MR imaging of the liver shows increased sensitivity compared to plain and spiral-CT in the evaluation of hepatic metastases. We think that MR superparamagnetic iron oxide should be used in all patients selected for liver resection.
本研究旨在比较1.5T超顺磁性氧化铁增强磁共振成像（MRI）和非增强MRI与螺旋计算机断层扫描（CT）的结果，以筛选适合肝切除的患者；术中超声（IOUS）为金标准。研究了35例已知结直肠肿瘤的肝切除候选患者；26例患者接受了手术，1例患者接受了射频消融，8例患者接受了随访。使用1.5T超导仪器进行MR检查，在Somatom-Plus（西门子）扫描仪上进行CT检查。定义了所有患者病变的大小和数量，以及螺旋CT和MR成像（使用平扫技术或钆喷酸葡胺增强后）的敏感性。在接受手术的患者中，将结果与IOUS结果进行了对比。26例患者共手术切除48个病变。CT检测到34个病变，3例假阳性；平扫MR成像检测到32个病变，而钆喷酸葡胺增强MR成像检测到41个病变。未接受手术的患者中，钆喷酸葡胺增强MR成像识别出15个病变，平扫MR成像和CT均显示8个病变。钆喷酸葡胺增强MR成像显示最小病变为6mm。在接受手术的病例中，CT敏感性为71%，平扫MR成像为66%，钆喷酸葡胺增强MR成像为85%。根据我们的经验，在评估肝转移瘤时，钆喷酸葡胺增强MR成像对肝脏的敏感性高于平扫和螺旋CT。我们认为，所有拟行肝切除的患者均应使用MR超顺磁性氧化铁。
