Division of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan.
Eur J Radiol. 2012 Apr;81(4):714-8. doi: 10.1016/j.ejrad.2011.01.123. Epub 2011 Feb 24.
To evaluate the magnetic resonance (MR) imaging feature of suspected hepatic metastasis in patients with malignant melanoma which showed intermediate findings on screened contrast-enhanced computed tomography (CECT).
MR imaging was performed in 38 patients (22 men, 16 women; mean age, 58 years) whose CECT findings were intermediate. Hepatic metastases had been diagnosed on MR imaging in 23 of the 38 patients. Verification of hepatic metastasis was made by histological examination: ultrasonographic-guided needle biopsy (n=3), autopsy (n=3), and surgical resection (n=1), or by an obvious progression in number and/or size of the lesions on follow-up MR imaging (n=24). Two diagnostic radiologists reviewed MR images by consensus. The median follow-up duration was 14.2 months.
Abnormal findings were detected in 31 patients on MR images, and undetected in the remaining seven patients resulting in false-positive on CECT. The mean size of the lesion was 11.0mm. False-positive results were obtained in two lesions which disappeared on follow-up MR imaging. In six patients, lesions were considered as hepatic cysts on MR images. As a result, a total of 35 hepatic metastases were detected on MR images. Of these, 18 patients demonstrated typical melanotic appearance on MR images which showed shortened T1 and T2 relaxation times, and five patients demonstrated atypical melanotic appearance. In 16 patients, extra-hepatic metastases were also developed.
MR imaging could rule out hepatic metastasis in patients with malignant melanoma which showed intermediate findings on screened CECT, and could detect additional extra-hepatic metastases.
评估在经筛查的对比增强 CT(CECT)显示为中等结果的恶性黑色素瘤患者中疑似肝转移的磁共振(MR)成像特征。
对 38 例患者(22 例男性,16 例女性;平均年龄 58 岁)进行了 MR 成像检查,这些患者的 CECT 结果为中等。38 例患者中有 23 例经 MR 成像诊断为肝转移。通过组织学检查证实肝转移:超声引导下经皮肝穿刺活检(n=3)、尸检(n=3)和手术切除(n=1),或通过随访 MR 成像上病变数量和/或大小的明显进展(n=24)。两位诊断放射科医生通过共识对 MR 图像进行了审查。中位随访时间为 14.2 个月。
在 31 例患者的 MR 图像上发现异常表现,而在其余 7 例患者中未发现异常表现,导致 CECT 出现假阳性。病变的平均大小为 11.0mm。在 2 个病变上获得了假阳性结果,这些病变在随访 MR 成像上消失。在 6 例患者中,病变在 MR 图像上被认为是肝囊肿。因此,共在 MR 图像上检测到 35 个肝转移灶。其中,18 例患者的 MR 图像表现出典型的黑色素瘤外观,表现为 T1 和 T2 弛豫时间缩短,5 例患者表现出非典型的黑色素瘤外观。在 16 例患者中,还发现了肝外转移。
MR 成像可排除在经筛查的 CECT 显示为中等结果的恶性黑色素瘤患者中存在肝转移,并可检测到额外的肝外转移。