Institute of Radiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2010 Jun;44(2):92-6. doi: 10.2478/v10019-010-0027-7. Epub 2010 May 24.
3T high-field magnetic resonance imaging (MRI) scanners have recently become available for the clinical use and are being increasingly applied in the field of whole-body imaging and chest imaging as well. The aim of this study was to evaluate the diagnostic potential of 3 T MRI as a complementary imaging modality to CT in detecting the pathological changes of asbestos-related thoracic diseases.
Fifteen patients with the asbestos-related thoracic disease were scheduled for 3T MRI. Five had a benign form of the disease and 10 had malignant pleural mesothelioma (MPM). From the patients with a benign form of the disease their last CT examination in digital form was acquired and patients with MPM were scheduled for CT examination with contrast media. The protocol of MR imaging consists of T2-weighted cardiac-gated breath-hold turbo spin echo (TSE) sequences in coronal, sagittal and axial plane and T1-weighted cardiac-gated breath-hold TSE black blood in axial plane. In T2-weighted sequences in axial plane, fat saturation was also used. CT examinations were obtained with the administration of the contrast medium from lung apices to the lower end of the liver. Images of 5 mm (mediastinum window) and 3 mm (lung window) in axial plan were reconstructed. MRI signal intensity of lesions and adjacent muscles on Syngo MultiModality Work Place were measured.
Compared to muscles pleural plaques appeared hypo-intense to iso-intense on T1 weighted images (in 100%) and also hypo-intense on T2 fs-weighted images (in 100%). MPM appeared inhomogeneous hypo-intense to iso-intense on T1-weighted and hyperintense on T2 fs-weighted images in all patients (100%).
These preliminary results pointed out that MRI was equal or even better compared with CT examination for detecting possible malignant potential of pleural changes in the asbestos-related pleural disease, using signal intensity measurements of T2 fs-weighted images. The 3T MRI enabled the accurate determination of chest pathology and it could be used for imaging of patients with the asbestos-related thoracic disease. MRI is particularly valuable because a patient is not exposed to the harmful radiation which is important if imaging methods are used repeatedly, like in screening programs or in monitoring of treatment results. This finding turned us to propose 3T MRI imaging technique as a non-ionizing imaging method for the follow-up of patients with the isolated pleural form of the asbestos-related disease.
3T 高场磁共振成像（MRI）扫描仪最近已可用于临床，并越来越多地应用于全身成像和胸部成像领域。本研究旨在评估 3T MRI 作为 CT 互补成像方式在检测与石棉相关的胸部疾病的病理变化中的诊断潜力。
15 例患有与石棉相关的胸部疾病的患者接受了 3T MRI 检查。其中 5 例为良性疾病，10 例为恶性胸膜间皮瘤（MPM）。对患有良性疾病的患者，获取其最后一次数字化 CT 检查，对患有 MPM 的患者安排进行 CT 检查，包括造影剂增强。MR 成像方案包括冠状位、矢状位和轴位 T2 加权心脏门控呼吸暂停涡轮自旋回波（TSE）序列，以及轴位 T1 加权心脏门控呼吸暂停 TSE 黑血序列。在轴位 T2 加权序列中，还使用了脂肪饱和技术。CT 检查在肺尖至肝下界给予造影剂后进行。轴位图像重建为 5mm（纵隔窗）和 3mm（肺窗）。在 Syngo MultiModality Work Place 上测量病变和相邻肌肉的 MRI 信号强度。
与肌肉相比，胸膜斑块在 T1 加权图像上呈低信号至等信号（100%），在 T2 fs 加权图像上也呈低信号（100%）。在所有患者中，MPM 在 T1 加权图像上呈不均匀低信号至等信号，在 T2 fs 加权图像上呈高信号（100%）。
这些初步结果表明，使用 T2 fs 加权图像的信号强度测量值，MRI 在检测与石棉相关的胸膜疾病中胸膜变化的可能恶性潜能方面与 CT 检查相当，甚至更好。3T MRI 能够准确确定胸部病变，并可用于与石棉相关的胸部疾病患者的成像。由于在重复使用成像方法（如筛查计划或监测治疗效果）时，患者不会受到有害辐射的影响，因此 MRI 特别有价值。这一发现促使我们提出 3T MRI 成像技术作为一种非电离成像方法，用于随访孤立性胸膜型与石棉相关疾病患者。
