Lee Minsu, Baek Song-Ee, Moon Jieun, Roh Yun Ho, Lim Joon Seok, Park Mi-Suk, Kim Myeong-Jin, Kim Honsoul
Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
Oncotarget. 2016 Jun 21;7(25):38513-38522. doi: 10.18632/oncotarget.9567.
To determine whether contrast-enhanced MRI including subtraction sequences can predict the treatment response of melanoma liver metastasis.
High precontrast T1 signal intensity (SI) of melanoma lesions obscured detection of enhancement after contrast injection. It was impossible to determine whether or not enhancement occurred in the majority of lesions (85.4%, n = 35/41) without including the subtraction technique. Positive enhancement was identified in 14.6% (n = 6/41) of patients without subtraction images, but increased to 68.3% (n = 28/41) by including subtraction images. Follow-up studies determined lesion progression in 34.1% (n = 14/41) of patients. Positive enhancement on the subtraction image (odds ratio = 12.1, P = 0.048) and intermediate high T2 SI (odds ratio = 8.16, P = 0.040) were significantly associated with higher risk of lesion progression.
Patients who underwent MRI for melanoma liver metastases between January 2007 and February 2015 were enrolled. The study analyzed 41 liver metastases in 15 patients [11 male and four female; median age 56 years (range 21-81)] for size, lesion enhancement with and without subtraction images, and T2 SI. Follow-up imaging studies were used to determine treatment response. Data were analyzed with generalized estimating equations.
MRI including the subtraction technique is useful for determining the treatment response of melanoma liver metastases. Lesion contrast enhancement and intermediate high T2 SI increased the risk of lesion progression.
确定包括减影序列在内的对比增强磁共振成像（MRI）是否能够预测黑色素瘤肝转移的治疗反应。
黑色素瘤病灶在对比剂注射前的高T1信号强度（SI）掩盖了注射对比剂后的强化检测。若不采用减影技术，大多数病灶（85.4%，n = 35/41）无法确定是否出现强化。在未采用减影图像的患者中，14.6%（n = 6/41）显示阳性强化，但采用减影图像后，这一比例增至68.3%（n = 28/41）。随访研究确定34.1%（n = 14/41）的患者病灶进展。减影图像上的阳性强化（优势比 = 12.1，P = 0.048）和中等偏高的T2 SI（优势比 = 8.16，P = 0.040）与病灶进展风险显著相关。
纳入2007年1月至2015年2月间因黑色素瘤肝转移接受MRI检查的患者。本研究分析了15例患者（11例男性，4例女性；中位年龄56岁，范围21 - 81岁）的41个肝转移灶，观察其大小、有无减影图像时的病灶强化情况以及T2 SI。采用随访成像研究来确定治疗反应。数据采用广义估计方程进行分析。
包括减影技术的MRI对于确定黑色素瘤肝转移的治疗反应有用。病灶对比增强和中等偏高的T2 SI增加了病灶进展的风险。
