Skillings J R, Bramwell V, Nicholson R L, Prato F S, Wells G
London Regional Cancer Center, Ontario, Canada.
Cancer. 1991 Apr 1;67(7):1838-43. doi: 10.1002/1097-0142(19910401)67:7<1838::aid-cncr2820670704>3.0.co;2-o.
In this prospective study, magnetic resonance imaging (MRI) was compared with computed tomography (CT) in patients with non-Hodgkin's lymphoma (NHDL), and with CT and laparotomy in patients with Hodgkin's disease (HD). Among 31 patients with NHDL, there was agreement between MRI and CT findings in 21 patients; MRI findings were positive and CT findings were negative in 8 patients; and MRI findings were negative and CT findings were positive in 2 patients. The false-negative findings of MRI included a laparotomy-proven mesenteric mass and a 6.6-cm lesion in the spleen, both shown by CT. In 13 evaluable patients with HD, there was agreement between MRI and laparotomy findings in 8 patients; MRI findings were positive and laparotomy findings were negative in 4 patients; and MRI findings were negative and laparotomy findings were positive in 1 patient. CT findings agreed with laparotomy findings in nine patients; CT findings were positive and laparotomy findings were negative in one patient: and CT findings were negative and laparotomy findings were positive in three patients. This suggested that MRI, although more sensitive than CT, was less specific with more false-positive findings. The spin-lattice relaxation time (T1) for the spleen was generally higher in patients with HD who had pathologically confirmed splenic involvement, and tended to increase with increasing spleen weight. This study was performed on a prototype 0.15 Tesla (Technicare Inc., Solon, OH) resistive unit at a time when methods and reporting for MRI were still being developed. Although MRI appears to have fewer false-negative findings than CT in evaluating the abdomen of lymphoma patients, the lack of a gastrointestinal contrast agent and specificity of T1 elevations in the spleen would not suggest that MRI could replace CT or laparotomy as a staging technique.
在这项前瞻性研究中，对非霍奇金淋巴瘤（NHDL）患者的磁共振成像（MRI）与计算机断层扫描（CT）进行了比较，并对霍奇金病（HD）患者的MRI与CT及剖腹探查进行了比较。在31例NHDL患者中，21例患者的MRI和CT检查结果一致；8例患者MRI检查结果为阳性而CT检查结果为阴性；2例患者MRI检查结果为阴性而CT检查结果为阳性。MRI的假阴性结果包括经剖腹探查证实的肠系膜肿块和脾脏内一个6.6厘米的病灶，两者CT均显示。在13例可评估的HD患者中，8例患者的MRI和剖腹探查结果一致；4例患者MRI检查结果为阳性而剖腹探查结果为阴性；1例患者MRI检查结果为阴性而剖腹探查结果为阳性。9例患者的CT检查结果与剖腹探查结果一致；1例患者CT检查结果为阳性而剖腹探查结果为阴性；3例患者CT检查结果为阴性而剖腹探查结果为阳性。这表明MRI虽然比CT更敏感，但特异性较差，假阳性结果更多。病理证实脾脏受累的HD患者，其脾脏的自旋晶格弛豫时间（T1）通常较高，且随脾脏重量增加而有升高趋势。本研究是在一台0.15特斯拉（Technicare公司，俄亥俄州索伦）的原型电阻式磁共振成像设备上进行的，当时MRI的方法和报告仍在发展中。虽然在评估淋巴瘤患者腹部时，MRI的假阴性结果似乎比CT少，但缺乏胃肠道造影剂以及脾脏T1升高的特异性并不表明MRI可以取代CT或剖腹探查作为分期技术。
