From the Departments of Diagnostic Radiology and Oncology (I.Y.), Pediatrics, Perinatal and Maternal Medicine (N.M.), Gastric Surgery (K. Kato, K. Kojima), Esophageal Surgery (T.K.), and Pathology (E.I., D.K., Y.E.), Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Physiology, Keio University School of Medicine, Tokyo, Japan (K.H., H.O.); and Central Institute for Experimental Animals, Kawasaki, Japan (K.H.).
Radiology. 2015 Jun;275(3):841-8. doi: 10.1148/radiol.14141878. Epub 2015 Jan 14.
To determine the imaging detail and diagnostic information that can be obtained at 7.0-T magnetic resonance (MR) imaging with a voxel volume of 9.5-14.0 nL as a means of evaluating the depth of mural invasion by gastric carcinomas ex vivo.
This study was approved by the institutional review board, and written informed consent was obtained from each patient. Twenty gastric specimens containing 20 carcinomas were studied with a 7.0-T MR imaging system equipped with a four-channel surface coil. MR images were obtained with a 50-60 × 25-30 mm field of view, a 512 × 256 matrix, and a 1.0-mm section thickness, resulting in a voxel volume of 0.0095-0.0140 mm(3) (9.5-14.0 nL). The signal intensity of the gastric wall layers, tumor tissue, and fibrosis was described as low, intermediate, or high by comparing it with the signal intensity of the muscularis propria. Depth of invasion initially was assessed by two reviewers independently and then by the two reviewers in consensus. MR images were compared with histopathologic findings.
The 7.0-T T2-weighted MR images clearly depicted the normal gastric wall in all 20 specimens (100%) as consisting of seven layers, which clearly corresponded to the tissue layers of the gastric wall. These MR images enabled clear differentiation between tumor tissue and fibrosis. Reviewers disagreed on the depth of invasion at the initial reading in three (15%) of 20 specimens (between mucosa and submucosa in two specimens and between muscularis propria and subserosa and serosa in one specimen); however, in all 20 gastric carcinomas, the depth of invasion could be accurately determined on T2-weighted images after consensus interpretation.
Ex vivo 7.0-T MR imaging enables clear delineation of the gastric wall layers and clear differentiation of tumor tissue from fibrosis and allows one to assess the depth of mural invasion by gastric carcinomas.
通过体素体积为 9.5-14.0 nL 的 7.0-T 磁共振(MR)成像来确定可以获得的成像细节和诊断信息,以此评估胃腺癌的壁内侵犯深度。
本研究获得机构审查委员会的批准,并获得每位患者的书面知情同意。使用配备有 4 通道表面线圈的 7.0-T MR 成像系统研究了 20 个包含 20 个癌的胃标本。MR 图像采用 50-60×25-30mm 的视野、512×256 矩阵和 1.0mm 的切片厚度获得,体素体积为 0.0095-0.0140mm3(9.5-14.0nL)。通过与固有肌层的信号强度相比,胃壁各层、肿瘤组织和纤维化的信号强度被描述为低、中或高。最初由两名审阅者独立评估侵犯深度,然后由两名审阅者达成共识进行评估。MR 图像与组织病理学发现进行比较。
在所有 20 个标本(100%)中,7.0-T T2 加权 MR 图像均清晰显示了正常胃壁,由 7 层组成,与胃壁的组织层明显对应。这些 MR 图像能够清晰地区分肿瘤组织和纤维化。在 20 个标本中的 3 个(15%)中,两名审阅者在最初的阅读中对侵犯深度存在分歧(在 2 个标本中位于黏膜和黏膜下层之间,在 1 个标本中位于固有肌层和浆膜下层和浆膜之间);然而,在所有 20 个胃腺癌中,在共识解释后,T2 加权图像可以准确确定壁内侵犯的深度。
离体 7.0-T MR 成像能够清晰描绘胃壁各层,并清晰区分肿瘤组织与纤维化,从而可以评估胃腺癌的壁内侵犯深度。