Gigli F, Brusori S, Bolognesi R, Sartoni Galloni S, Mancini A, Bonsi S, Rosito P
Servizio di Radiologia, Ospedale Maggiore, Bologna.
Radiol Med. 1991 Oct;82(4):415-21.
Eleven patients suffering from neuroblastoma and Wilms' tumor were examined with MR imaging (25 examinations). The results were compared with those obtained with other diagnostic methods--e.g. CT--to verify MR reliability in locating and staging the lesions. Signal patterns were studied, as recorded on T1- and T2-weighted sequences using various repetition and echo times. An attempt was made to verify the presence of pathognomonic findings and to differentiate tumors from post-therapy fibroses. All findings were subsequently confirmed at biopsy or, in the patients who underwent surgery, by surgical findings. To carry out all the procedures, the patients had to be sedated or to be administered a general anesthetic. When possible, a brain or surface coil was used to obtain a clear, well-defined image in thin-section (7-8 mm) sequences. MR imaging allowed all lesions to be detected and located in the examined population. A large thrombus in the vena cava and local adenopathy were observed in a patients suffering from Wilms' tumor. Spread into the spinal canal was present in 2 cases of neuroblastoma. One of the main advantages of MR imaging is its multiplanarity which usually allows lesion extent to be demonstrated, together with the involved organs. The additional advantages of MR imaging over CT should not be underestimated. MR allows images of the abdomen to be obtained devoid of respiratory artifacts and provides a sharp contrast between pathological and healthy tissue without contrast medium administration. In all the patients who underwent it, MR imaging proved superior to CT in the evaluation of the intraspinal spread of paraspinal lesions. MR also allowed serial follow-up to be carried out, with no risk of subsequent proteximetric problems, thus helping distinguish tumor masses from fibrous tissue in all patients.
对11例患有神经母细胞瘤和肾母细胞瘤的患者进行了磁共振成像检查(共25次检查)。将结果与其他诊断方法(如CT)所获结果进行比较,以验证磁共振成像在病变定位和分期方面的可靠性。研究了在不同重复时间和回波时间的T1加权和T2加权序列上记录的信号模式。试图验证特征性表现的存在,并将肿瘤与治疗后纤维化区分开来。所有结果随后均经活检证实,或在接受手术的患者中经手术结果证实。为了进行所有这些检查,患者必须接受镇静或全身麻醉。可能的情况下,使用头部或表面线圈在薄层(7 - 8毫米)序列中获取清晰、明确的图像。磁共振成像能够检测并定位所有受检人群中的病变。在1例肾母细胞瘤患者中观察到腔静脉内有大血栓及局部淋巴结病。2例神经母细胞瘤患者出现肿瘤蔓延至椎管。磁共振成像的一个主要优点是其多平面性,通常能够显示病变范围以及受累器官。不应低估磁共振成像相对于CT的其他优势。磁共振成像能够获取无呼吸伪影的腹部图像,并且在不使用造影剂的情况下就能在病理组织和健康组织之间提供清晰的对比。在所有接受磁共振成像检查的患者中,在评估椎旁病变的椎管内蔓延方面,磁共振成像被证明优于CT。磁共振成像还能进行连续随访,不存在后续辐射剂量问题的风险,从而有助于在所有患者中区分肿瘤肿块与纤维组织。