Fogarty G B, Tartaguia C
Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.
Clin Oncol (R Coll Radiol). 2006 May;18(4):360-2. doi: 10.1016/j.clon.2006.01.002.
To retrospectively evaluate the use of brain magnetic resonance imaging (MRI) in the initial staging of patients with cutaneous melanoma in our melanoma unit.
The radiology request forms for brain MRI for melanoma staging for 193 consecutive patients were reviewed. Patient hospital records were also retrospectively reviewed. Patients with no histological confirmation of a cutaneous primary or patients whose scan was to primarily investigate their neurological symptoms were excluded. Records were also searched for incidental symptoms that may have been associated with brain metastases.
One hundred patients were eligible. No patients were upstaged by MRI. Of a total of 33 patients already graded as stage IV by prior staging, 11 (33%) were found to have brain metastases. No patients graded less than stage IV were found to have brain metastases on MRI. Six out of 12 patients with incidental symptoms had metastases. Five patients graded as stage IV had asymptomatic brain metastases.
We recommend brain MRI only for patients with stage IV disease and for other patients with melanoma contemplating further adjuvant therapy where brain metastases would change management.
回顾性评估在我们黑色素瘤科室中，脑磁共振成像（MRI）在皮肤黑色素瘤患者初始分期中的应用。
回顾了193例连续进行黑色素瘤分期脑MRI检查的放射学申请单。同时也回顾性查阅了患者的医院记录。排除没有皮肤原发灶组织学确诊的患者或扫描主要用于调查其神经症状的患者。还在记录中查找可能与脑转移相关的偶然症状。
100例患者符合条件。没有患者因MRI检查而被重新分期。在之前分期已判定为IV期的33例患者中，11例（33%）被发现有脑转移。MRI检查未发现分期低于IV期的患者有脑转移。12例有偶然症状的患者中有6例有转移。5例IV期患者有无症状脑转移。
我们建议仅对IV期疾病患者以及考虑进一步辅助治疗且脑转移会改变治疗方案的其他黑色素瘤患者进行脑MRI检查。
