Stimac G K, Porter B A, Olson D O, Gerlach R, Genton M
First Hill Diagnostic Imaging Center, Seattle, WA 98104.
AJR Am J Roentgenol. 1988 Dec;151(6):1185-92. doi: 10.2214/ajr.151.6.1185.
Unenhanced T1- and T2-weighted spin-echo, short inversion time inversion recovery (STIR), and gadolinium-DTPA (Gd-DTPA)-enhanced spin-echo and STIR imaging techniques were used in 20 patients as part of a multicenter study to assess the safety and efficacy of Gd-DTPA in spinal imaging. Five patients had normal MR scans. Of those with lesions, both Gd-DTPA-enhanced T1-weighted spin-echo and unenhanced STIR scans improved detection and evaluation of spinal tumors over conventional spin-echo methods, particularly T2-weighted spin echo, by providing higher tissue contrast in shorter imaging times. The Gd-DTPA-enhanced T1-weighted spin-echo scans were most helpful in evaluating intradural tumors, whereas STIR sequences were most effective for extradural tumors and bone metastases. In most cases, Gd-DTPA-enhanced T1-weighted spin-echo scans best delineated tumor margins, and the enhancement was helpful in suggesting a cellular or active nature of the lesions. In some cases, the enhancement resulted in a more homogeneous and thus less abnormal-appearing marrow in vertebrae involved by tumor; therefore, a precontrast T1-weighted spin-echo scan is necessary in all patients who are to be studied with Gd-DTPA. A combined approach that uses T1-weighted spin-echo, Gd-DTPA-enhanced T1-weighted spin-echo, and STIR images currently appears optimal for MR imaging of spinal neoplasms. T2-weighted spin-echo images add information only in occasional cases.
作为一项多中心研究的一部分，对20例患者使用了非增强T1加权和T2加权自旋回波、短反转时间反转恢复（STIR）以及钆喷酸葡胺（Gd-DTPA）增强自旋回波和STIR成像技术，以评估Gd-DTPA在脊柱成像中的安全性和有效性。5例患者的磁共振成像（MR）扫描结果正常。在有病变的患者中，Gd-DTPA增强T1加权自旋回波扫描和非增强STIR扫描相比于传统自旋回波方法，尤其是T2加权自旋回波，在更短的成像时间内提供了更高的组织对比度，从而改善了脊柱肿瘤的检测和评估。Gd-DTPA增强T1加权自旋回波扫描在评估硬膜内肿瘤方面最有帮助，而STIR序列对硬膜外肿瘤和骨转移最为有效。在大多数情况下，Gd-DTPA增强T1加权自旋回波扫描能最佳地勾勒出肿瘤边缘，且这种强化有助于提示病变的细胞性或活跃性。在某些情况下，强化使得受累椎体骨髓更均匀，因而外观上不那么异常；因此，对于所有要用Gd-DTPA进行研究的患者，均需进行对比前T1加权自旋回波扫描。目前，联合使用T1加权自旋回波、Gd-DTPA增强T1加权自旋回波和STIR图像的方法似乎是脊柱肿瘤MR成像的最佳选择。T2加权自旋回波图像仅在偶尔情况下能增加信息。
