Demas B E, Heelan R T, Lane J, Marcove R, Hajdu S, Brennan M F
Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
AJR Am J Roentgenol. 1988 Mar;150(3):615-20. doi: 10.2214/ajr.150.3.615.
A prospective comparison of the accuracy of MR and CT in determining the anatomic extent of disease was carried out in 40 patients who had histologically proved soft-tissue sarcomas of the extremities. Tumor resection, performed by using either en bloc excision or amputation in all patients, allowed detailed pathologic verification of imaging findings. Image analysis included measurement of maximum tumor dimensions, notation of tumor position in relation to deep fascia, recording of anatomic compartment and individual muscle involvement, and documentation of the spatial relationships between tumor, neurovascular structures, underlying bones, and joints. MR and CT were equally accurate in measurement of maximal tumor diameter, detection of tumor depth, and delineation of tumor, neurovascular, osseous, and articular relationships. Evaluation of anatomic compartment and individual muscle involvement was more accurately accomplished with MR imaging; nine (23%) of 40 MR studies showed tumor involvement of one or more individual muscles that appeared normal in CT scans. These results suggest that MR imaging may be the staging procedure of choice in patients with soft-tissue sarcomas of the extremities.
对40例经组织学证实为四肢软组织肉瘤的患者进行了一项前瞻性比较，以评估磁共振成像（MR）和计算机断层扫描（CT）在确定疾病解剖范围方面的准确性。所有患者均采用整块切除或截肢进行肿瘤切除，从而能够对影像学检查结果进行详细的病理验证。图像分析包括测量肿瘤最大尺寸、标注肿瘤相对于深筋膜的位置、记录解剖间隔和单个肌肉受累情况，以及记录肿瘤与神经血管结构、深层骨骼和关节之间的空间关系。在测量肿瘤最大直径、检测肿瘤深度以及描绘肿瘤与神经血管、骨骼和关节的关系方面，MR和CT的准确性相当。通过MR成像能更准确地评估解剖间隔和单个肌肉受累情况；40例MR检查中有9例（23%）显示肿瘤累及一个或多个在CT扫描中看似正常的单个肌肉。这些结果表明，MR成像可能是四肢软组织肉瘤患者分期检查的首选方法。
