Pauls Sandra, Mottaghy Felix M, Schmidt Stefan A, Krüger Stefan, Möller Peter, Brambs Hans-Jürgen, Wunderlich Arthur
Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
Magn Reson Imaging. 2008 Dec;26(10):1334-41. doi: 10.1016/j.mri.2008.04.005. Epub 2008 Jun 5.
The characterization of solid pulmonary lesions with imaging methods remains a diagnostic challenge. The aim of this study was to correlate kinetic parameters of dynamic perfusion magnetic resonance imaging (MRI) with histological tumor classification. Dynamic contrast-enhanced MRI of 31 patients with pulmonary masses (five benign lesions, 26 malignant tumors) was acquired in the tumor areas every 20 s for a mean duration of 124 s. Contrast uptake (CU) was measured by signal analysis in regions of interest (ROIs). The beginning and duration of CU, maximum CU (MCU, % of baseline), maximum contrast upslope (%/s) and the delay to the maximum contrast upslope (s) were calculated. All lesions were classified histologically. The beginning of CU correlated significantly with the MCU delay in all lesions (P=.033). The frequency of a plateau phase was higher in malignant tumors compared to benign lesions (P=.031). Masses with a high MCU showed more frequently a washout of contrast medium after a plateau phase (P=.006) and a higher maximum contrast upslope (P<.001). The MCU delay time was shorter in adenocarcinoma than in squamous cell carcinoma (P=.004). These results indicate that dynamic contrast enhanced MRI might become instrumental in differentiating benign from malignant intrapulmonary tumors and distinguishing adenocarcinoma from squamous cell carcinoma.
利用成像方法对肺部实性病变进行特征描述仍然是一项诊断挑战。本研究的目的是将动态灌注磁共振成像（MRI）的动力学参数与组织学肿瘤分类相关联。对31例肺部肿块患者（5例良性病变，26例恶性肿瘤）进行动态对比增强MRI检查，在肿瘤区域每20秒采集一次图像，平均持续时间为124秒。通过感兴趣区域（ROI）的信号分析测量对比剂摄取（CU）。计算CU的起始时间和持续时间、最大CU（MCU，相对于基线的百分比）、最大对比剂上升斜率（%/秒）以及达到最大对比剂上升斜率的延迟时间（秒）。所有病变均进行组织学分类。在所有病变中，CU的起始时间与MCU延迟显著相关（P = 0.033）。与良性病变相比，恶性肿瘤出现平台期的频率更高（P = 0.031）。MCU高的肿块在平台期后更频繁地出现对比剂洗脱（P = 0.006），且最大对比剂上升斜率更高（P < 0.001）。腺癌的MCU延迟时间比鳞状细胞癌短（P = 0.004）。这些结果表明，动态对比增强MRI可能有助于鉴别肺内肿瘤的良恶性以及区分腺癌和鳞状细胞癌。
