Boechat M I, Kangarloo H, Ortega J, Hall T, Feig S, Stanley P, Gilsanz V
Department of Radiological Sciences, UCLA Medical Center 90024.
Radiology. 1988 Dec;169(3):727-32. doi: 10.1148/radiology.169.3.2847233.
A prospective study was performed at two institutions to determine the role of magnetic resonance (MR) imaging in the evaluation of primary pediatric liver tumors. The study compared the usefulness of MR imaging and computed tomography (CT) in providing a correct diagnosis, assessing resectability, and determining tumor recurrence in 23 children with liver tumors. The information obtained with both modalities was correlated with surgical data. The results indicate that the accuracy of MR imaging in helping to differentiate benign from malignant lesions is high and identical to that of CT, but not good enough to obviate surgical diagnosis. While all five hepatocellular carcinomas were correctly diagnosed preoperatively with both modalities, neither CT nor MR imaging could help differentiate these carcinomas from aggressive hepatoblastoma or primary hepatic lymphoma. MR imaging helped correctly predict tumor resectability in all 18 children with malignant hepatic tumors; in one, exact tumor extension was misjudged with CT. Postoperative MR studies suggested tumor recurrence in three children who had unremarkable CT examinations. Second-look surgery showed recurrent tumor in two and fibrosis with chronic inflammation at the surgical margin in the third child.
在两家机构开展了一项前瞻性研究，以确定磁共振（MR）成像在评估小儿原发性肝肿瘤中的作用。该研究比较了MR成像和计算机断层扫描（CT）在23例肝肿瘤患儿中进行正确诊断、评估可切除性以及确定肿瘤复发方面的效用。通过这两种方式获得的信息与手术数据相关。结果表明，MR成像在鉴别良性与恶性病变方面的准确性很高，与CT相同，但尚不足以排除手术诊断。虽然两种方式均在术前正确诊断出了所有5例肝细胞癌，但CT和MR成像均无法将这些癌与侵袭性肝母细胞瘤或原发性肝淋巴瘤区分开来。MR成像有助于正确预测所有18例恶性肝肿瘤患儿的肿瘤可切除性；其中1例患儿的肿瘤确切范围被CT误判。术后MR检查提示3例CT检查无异常的患儿出现肿瘤复发。二次手术显示，2例患儿存在复发性肿瘤，第3例患儿手术切缘为纤维化伴慢性炎症。
