Shimojo M, Tsuda N, Kamihata H, Inada M, Kato T, Sawada S, Tanaka Y
Second Department of Internal Medicine, Kansai Medical University, Moriguchi.
J Cardiol. 1989 Jun;19(2):583-92.
We examined 10 patients with cardiovascular masses using 0.15 tesla permanent magnetic resonance imaging (MRI) incorporating an ECG-gated spin echo technique, and investigated the usefulness of MRI in the noninvasive diagnosis of cardiovascular masses. Patients were one with rhabdomyoma, one with leiomyosarcoma, one with malignant mesothelioma (diffuse type), three with pulmonary arterial invasions by lung carcinoma, one with left atrial invasion by lung carcinoma, and three with the superior vena cava (SVC) syndrome. 1. Each image obtained with TE of 40 msec, and TR of one R-R interval clearly defined the mass by its intermediate signal intensity. 2. In the case of rhabdomyoma occupying the right ventricle, leiomyosarcoma growing from the inferior vena cava into the right atrium and malignant mesothelioma diffusely invading the mediastinum, the morphology and the extent of each mass in relation to the surrounding structures were distinctly identified in the coronal, sagittal or oblique sections for situation, in addition to the routine transaxial section. 3. In the cases of pulmonary arterial invasion by lung carcinoma and the SVC syndrome, the masses invading the pulmonary artery or narrowing large vessels were clearly separated from adjacent structures on the sections through each of the large vessels. 4. In the case without left atrial invasion, which was proved by autopsy, a high intensity line due to mediastinal fat demarcated the mass distinctly. This finding is a useful sign for evaluating the extension of a tumor. 5. The image obtained with TE of 80 msec, and TR of double R-R interval (long SE image) showed a different contrast from the image obtained with TE of 40 msec and TR of one R-R interval. Leiomyosarcoma had a more heterogenous intensity on the long SE image which may result from a different T2 value caused by necrotic, edematous or fibrotic changes within the tumor. These results indicate that MRI also provides some information about the differentiation between benign and malignant masses.
我们使用结合了心电图门控自旋回波技术的0.15特斯拉永磁磁共振成像(MRI)对10例患有心血管肿块的患者进行了检查,并研究了MRI在心血管肿块无创诊断中的实用性。患者包括1例横纹肌瘤、1例平滑肌肉瘤、1例恶性间皮瘤(弥漫型)、3例肺癌侵犯肺动脉、1例肺癌侵犯左心房以及3例上腔静脉(SVC)综合征患者。1. 采用40毫秒的回波时间(TE)和一个R-R间期的重复时间(TR)获得的每张图像,因其中等信号强度清晰地界定了肿块。2. 对于占据右心室的横纹肌瘤、从下腔静脉长入右心房的平滑肌肉瘤以及弥漫性侵犯纵隔的恶性间皮瘤,除了常规的横轴位切片外,在冠状位、矢状位或斜位切片中,还能清楚地识别出每个肿块相对于周围结构的形态和范围。3. 在肺癌侵犯肺动脉和SVC综合征的病例中,侵犯肺动脉或使大血管变窄的肿块在穿过各条大血管的切片上与相邻结构清晰分开。4. 在经尸检证实无左心房侵犯的病例中,纵隔脂肪产生的高强度线清晰地勾勒出肿块。这一发现是评估肿瘤扩展的有用征象。5. 采用80毫秒的TE和双倍R-R间期(长SE图像)获得的图像与采用40毫秒的TE和一个R-R间期获得的图像具有不同的对比度。平滑肌肉瘤在长SE图像上的信号强度更不均匀,这可能是由于肿瘤内坏死、水肿或纤维化改变导致的不同T2值所致。这些结果表明,MRI也能提供一些关于良性和恶性肿块鉴别的信息。