Grott Matthias, Khan Nabil, Eichhorn Martin E, Heussel Claus Peter, Winter Hauke, Eichinger Monika
Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Roentgenstrasse 1, 69126 Heidelberg, Germany.
Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Im Neuenheimer Feld 130.3, 69126 Heidelberg, Germany.
Cancers (Basel). 2024 Sep 15;16(18):3162. doi: 10.3390/cancers16183162.
Contrast-enhanced computed tomography (CT) is the standard radiologic examination for evaluating the extent of mediastinal tumors. If tumor infiltration into the large central thoracic vessels, the pericardium, or the myocardium is suspected, cine magnetic resonance imaging (cine-MRI) can provide additional valuable information. We conducted a retrospective study of patients with mediastinal tumors who were staged with CT, cine-MRI, and a T1-weighted turbo spin echo (T1TSE) prior to surgical resection. Imaging was re-evaluated regarding tumor infiltration into the pericardium, myocardium, superior vena cava, aorta, pulmonary arteries, and atria and compared with intraoperative findings and postoperative histopathological reports (gold standard). Unclear CT findings were further investigated. Forty-seven patients (29 female and 18 male patients; median age: 58 years) met the inclusion criteria. Cine-MRI was able to predict infiltration of the aorta in 86%, pulmonary arteries in 85%, and atria in 80% of unclear CT cases. Aortic tumor infiltration in unclear CT cases was significantly more often correctly diagnosed with cine-MRI than with T1TSE sequence. Additional cine-MRI is of crucial benefit in unclear CT cases. We recommend performing cine-MRI if infiltration into the large central vessels and atria is suspected. T1TSE sequence is of very limited additional value.
增强计算机断层扫描（CT）是评估纵隔肿瘤范围的标准影像学检查。如果怀疑肿瘤浸润到大的中央胸段血管、心包或心肌，电影磁共振成像（cine-MRI）可提供额外的有价值信息。我们对纵隔肿瘤患者进行了一项回顾性研究，这些患者在手术切除前接受了CT、cine-MRI和T1加权快速自旋回波（T1TSE）检查以进行分期。对关于肿瘤浸润心包、心肌、上腔静脉、主动脉、肺动脉和心房的影像学检查进行了重新评估，并与术中发现及术后组织病理学报告（金标准）进行比较。对不明确的CT检查结果进行了进一步研究。47例患者（29例女性和18例男性患者；中位年龄：58岁）符合纳入标准。在不明确的CT病例中，cine-MRI能够预测86%的主动脉浸润、85%的肺动脉浸润和80%的心房浸润。在不明确的CT病例中，cine-MRI对主动脉肿瘤浸润的正确诊断明显比T1TSE序列更常见。在不明确的CT病例中，额外的cine-MRI具有至关重要的益处。如果怀疑浸润到大的中央血管和心房，我们建议进行cine-MRI检查。T1TSE序列的附加价值非常有限。
