Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China.
Department of Burn and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, P.R. China.
Skin Res Technol. 2021 Jul;27(4):511-520. doi: 10.1111/srt.12978. Epub 2020 Nov 3.
While uncomplicated cases of skin squamous cell carcinoma (cSCC) can be treated with surgery topical therapy alone, more objective and non-invasive examination methods are needed to guide clinicians to make more detailed biopsy and surgical plans for lesions with atypical or subcutaneous growth. High-resolution magnetic resonance imaging (HR-MRI) is a novel skin imaging method.
Prospective collection of 19 patients with clinically suspected cSCC. All patients underwent high-resolution DCE-MRI using a 70-mm microscopy coil before operation. The imaging features and results of surgical pathology were recorded. K , K , V values, and the time-signal curve (TIC) types were determined using DCE images.
16 cases of cSCC, 3 cases of acanthoma. The subcutaneous invasion of all lesions was clearly displayed, of which 8 lesions invaded the subcutaneous fat layer, 5 invaded the muscle layer, 1 invaded the periosteum, 2 invaded the cap fascia, and the layer of all lesions invasion judged by HR-MR imaging was consistent with the postoperative pathology. The main manifestations of cSCC were ill-defined margin, obvious inhomogeneous enhancement, higher perfusion parameters value and type-III TIC, while acanthoma showed well-defined and type-I TIC. Some imaging findings (such as boundary, enhancement) and DCE perfusion parameters of the two groups overlap.
High-resolution DCE-MRI can fully and directly display the subcutaneous invasion of cSCC, and more work needs to be done to prove its value. Next, we will expand the sample size, and further explore its value in the differential diagnosis and prognosis evaluation of cSCC from acanthoma or other skin tumors.
对于无并发症的皮肤鳞状细胞癌（cSCC），单纯手术或局部治疗即可，但对于具有非典型或皮下生长方式的病变，需要更客观、非侵入性的检查方法来指导临床医生制定更详细的活检和手术计划。高分辨率磁共振成像（HR-MRI）是一种新的皮肤成像方法。
前瞻性收集 19 例临床疑似 cSCC 患者。所有患者均在术前采用 70mm 显微镜线圈进行高分辨率 DCE-MRI 检查。记录影像学特征和手术病理结果。使用 DCE 图像确定 K 、 K 、 V 值和时间信号曲线（TIC）类型。
16 例 cSCC，3 例棘皮瘤。所有病变的皮下侵犯均清晰显示，其中 8 例侵犯皮下脂肪层，5 例侵犯肌肉层，1 例侵犯骨膜，2 例侵犯帽状筋膜，HR-MR 成像判断的所有病变侵犯层与术后病理一致。cSCC 的主要表现为边界不清、不均匀强化明显、灌注参数值较高且 TIC 呈Ⅲ型，而棘皮瘤表现为边界清楚且 TIC 呈Ⅰ型。两组的一些影像学表现（如边界、强化）和 DCE 灌注参数存在重叠。
高分辨率 DCE-MRI 能充分、直接地显示 cSCC 的皮下侵犯，需要进一步研究以证实其价值。接下来，我们将扩大样本量，进一步探讨其在 cSCC 与棘皮瘤或其他皮肤肿瘤的鉴别诊断和预后评估中的价值。
