Sheng Meiying, Tang Mengxiao, Lin Wei, Guo Lingchuan, He Wenjun, Chen Weixin, Li Ke, Liu Jianjiang, Xiao Can, Li Yonggang
Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China.
Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, P.R.China.
Skin Res Technol. 2021 Jan;27(1):62-69. doi: 10.1111/srt.12909. Epub 2020 Jul 11.
The extent and depth of facial nonmelanoma skin cancers and the involvement of adjacent structures are critical features for surgical planning, but they are difficult to assess clinically. High-resolution MRI (HR-MRI) with microscopy coil may facilitate detailed evaluation of skin lesions. The authors performed this prospective study to determine the value of high-resolution microscopy coil MRI in the preoperative evaluation of nonmelanoma skin cancer.
Between October 2018 and August 2019, 16 lesions from fifteen consecutive patients with facial nonmelanoma skin cancer were evaluated using high-resolution microscopy coil MRI about tumor extent, depth, margins, characteristic, and their spatial relationship with adjacent structures. The preoperative HR-MRI results were compared with the intraoperative findings and with the histopathology, with special note to the depth of invasion.
Among the 16 lesions, HR-MRI imaging was found to provide accurate evaluation of tumor extent, depth, and margins and determine whether there was involvement of adjacent structures. The tumor depth measured on HR-MRI showed good correlation with histopathologic results (CCC: 0.973), and Bland-Altman analysis finding no significant bias existed between the two measurements. All lesions except one were completely resected with primary excision. Only one lesion required further excision. During follow-up for 3-15 months, no tumor recurrence was observed in any case.
HR-MRI is an accurate, noninvasive imaging technique that can be used as preoperative evaluation tool for facial nonmelanoma skin cancer. It can accurate predict tumor depth, margins, and involvement of structure. The valuable information it provided facilitates surgeons optimize surgical planning.
面部非黑色素瘤皮肤癌的范围、深度以及相邻结构的受累情况是手术规划的关键特征，但临床上难以评估。使用显微镜线圈的高分辨率磁共振成像（HR-MRI）有助于对皮肤病变进行详细评估。作者开展了这项前瞻性研究，以确定高分辨率显微镜线圈MRI在非黑色素瘤皮肤癌术前评估中的价值。
2018年10月至2019年8月期间，对15例连续性面部非黑色素瘤皮肤癌患者的16个病灶进行了高分辨率显微镜线圈MRI检查，评估肿瘤的范围、深度、边缘、特征及其与相邻结构的空间关系。将术前HR-MRI结果与术中发现及组织病理学结果进行比较，特别关注浸润深度。
在这16个病灶中，发现HR-MRI成像能够准确评估肿瘤的范围、深度和边缘，并确定相邻结构是否受累。HR-MRI测量的肿瘤深度与组织病理学结果显示出良好的相关性（CCC：0.973），Bland-Altman分析表明两次测量之间不存在显著偏差。除1个病灶外，所有病灶均通过一期切除完全切除。只有1个病灶需要进一步切除。在3至15个月的随访期间，未观察到任何病例出现肿瘤复发。
HR-MRI是一种准确的非侵入性成像技术，可作为面部非黑色素瘤皮肤癌的术前评估工具。它能够准确预测肿瘤深度、边缘及结构受累情况。其提供的有价值信息有助于外科医生优化手术规划。
