Kellenberger Christian J, Miller Stephen F, Khan Mustafa, Gilday David L, Weitzman Sheila, Babyn Paul S
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada.
Eur Radiol. 2004 Oct;14(10):1829-41. doi: 10.1007/s00330-004-2432-z. Epub 2004 Sep 9.
Our objective was to compare fast spin-echo (FSE) short inversion time inversion recovery (STIR) whole-body MR imaging with standard procedures in staging children with lymphoma. Eight children (age range, 2-16 years) underwent multi-station FSE STIR whole-body MR at initial staging (n=5) or for restaging following completion of therapy (n=5). Whole-body MR and conventional staging procedures, including CT (n=10), gallium-67 scintigraphy (n=9), bone scintigraphy (n=3) and bone marrow biopsy (n=7) were retrospectively compared for detection of sites involved by lymphoma and for the assigned stage. FSE STIR whole-body MR detected more sites of possible lymphomatous involvement at initial staging (87/88) and at restaging (5/5) than did conventional imaging (74/88, 3/5). MR was more sensitive than conventional imaging in detecting bone marrow involvement at initial staging. Following treatment, however, residual and therapy-induced bone marrow signal abnormalities could not be differentiated from lymphomatous involvement. Detection of nodal and visceral involvement correlated well. Our results suggest that FSE STIR whole-body MR imaging is a sensitive technique for evaluating lymphomatous involvement of bone marrow as well as non-marrow sites. Larger prospective trials are needed to determine if FSE STIR whole-body MR can replace standard radiographic procedures for initial staging and contribute in the follow-up of lymphoma in children.
我们的目的是比较快速自旋回波(FSE)短反转时间反转恢复(STIR)全身磁共振成像与标准程序在淋巴瘤患儿分期中的应用。8名儿童(年龄范围2至16岁)在初始分期时(n = 5)或治疗完成后进行再分期时(n = 5)接受了多部位FSE STIR全身磁共振检查。对全身磁共振成像和传统分期程序进行回顾性比较,这些传统程序包括CT(n = 10)、镓-67闪烁扫描(n = 9)、骨闪烁扫描(n = 3)和骨髓活检(n = 7),以检测淋巴瘤累及部位并确定分期。FSE STIR全身磁共振成像在初始分期(87/88)和再分期(5/5)时检测到的可能淋巴瘤累及部位比传统成像(74/88,3/5)更多。在初始分期时,磁共振成像在检测骨髓受累方面比传统成像更敏感。然而,治疗后,残留的和治疗引起的骨髓信号异常无法与淋巴瘤累及相区分。淋巴结和内脏受累的检测相关性良好。我们的结果表明,FSE STIR全身磁共振成像是评估骨髓以及非骨髓部位淋巴瘤累及的一种敏感技术。需要进行更大规模的前瞻性试验来确定FSE STIR全身磁共振成像是否可以取代标准的放射学程序进行初始分期,并有助于儿童淋巴瘤的随访。