Russell E J, Geremia G K, Johnson C E, Huckman M S, Ramsey R G, Washburn-Bleck J, Turner D A, Norusis M
Department of Diagnostic Radiology, Northwestern University Medical School, Northwestern Memorial Hospital, Chicago, IL 60611.
Radiology. 1987 Dec;165(3):609-17. doi: 10.1148/radiology.165.3.3317495.
Sixteen patients with suspected cerebral metastases were studied with magnetic resonance (MR) imaging before and after the intravenous administration of 0.1 mmol/kg of gadolinium diethylenetriaminepenta-acetic acid. The images were interpreted blindly by two neuroradiologists; all clinical, radiologic (computed tomographic and MR imaging), and pathologic data were reviewed to arrive at a final "best diagnosis," which was then compared with the prior blinded interpretations. Of seven patients found to have multiple metastases, six (86%) had at least one tumor nodule depicted by postinfusion MR imaging that was missed by one or both observers on review of preinfusion images alone. Lesions missed on preinfusion studies were usually small nodules hidden by or not detected next to regions of high-signal edema thought to be related to the adjacent tumor nodule. The authors believe that contrast enhancement improves detection of metastatic foci with MR imaging and that the findings indicate broader implications for the detection of multiple lesions from other causes.
对16例疑似脑转移瘤的患者静脉注射0.1 mmol/kg的钆喷酸葡胺前后进行了磁共振（MR）成像研究。图像由两名神经放射科医生进行盲法解读；回顾了所有临床、放射学（计算机断层扫描和MR成像）及病理数据，以得出最终的“最佳诊断”，然后将其与之前的盲法解读结果进行比较。在7例发现有多发转移瘤的患者中，6例（86%）在注射造影剂后的MR成像中显示出至少一个肿瘤结节，而仅回顾注射造影剂前的图像时，一名或两名观察者均未发现该结节。注射造影剂前检查遗漏的病变通常是被认为与相邻肿瘤结节相关的高信号水肿区域掩盖或未被检测到的小结节。作者认为，对比增强可提高MR成像对转移灶的检测能力，且这些发现提示对检测其他原因导致的多发病变具有更广泛的意义。
