恶性肿瘤患者的肾上腺肿块：回波平面成像、快速自旋回波成像和化学位移磁共振成像的前瞻性比较
Adrenal masses in patients with malignancy: prospective comparison of echo-planar, fast spin-echo, and chemical shift MR imaging.
作者信息
Schwartz L H, Panicek D M, Koutcher J A, Brown K T, Getrajdman G I, Heelan R T, Burt M
机构信息
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
出版信息
Radiology. 1995 Nov;197(2):421-5. doi: 10.1148/radiology.197.2.7480686.
PURPOSE
To assess echo-planar, fast spin-echo (SE), and chemical shift magnetic resonance (MR) imaging in differentiation of adrenal adenomas from malignant adrenal masses in patients with known malignancy.
MATERIALS AND METHODS
Sixty-eight adrenal masses (23 malignant, 45 benign) in 68 patients with known malignancy were examined with echo-planar, fast SE with and without fat suppression, and chemical shift pulse sequences.
RESULTS
With a cutoff T2 value of 75 msec, the sensitivity of echo-planar imaging for benign lesions was 82%, and specificity was 96%. With a cutoff adrenal mass-to-spleen signal intensity ratio of 0.80, the sensitivity of fast SE imaging for benign lesions was 53%, and specificity was 96%. With a cutoff adrenal mass-to-spleen ratio of 0.55, the sensitivity of chemical shift imaging for benign lesions was 80], and specificity was 100%.
CONCLUSION
Chemical shift imaging and calculated T2 values from echo-planar imaging are promising techniques for differentiation of adrenal adenomas from malignant adrenal masses and can obviate biopsy.
目的
评估回波平面成像、快速自旋回波（SE）成像以及化学位移磁共振（MR）成像在已知患有恶性肿瘤的患者中鉴别肾上腺腺瘤与肾上腺恶性肿块的能力。
材料与方法
对68例已知患有恶性肿瘤的患者的68个肾上腺肿块（23个恶性，45个良性）进行了回波平面成像、有无脂肪抑制的快速SE成像以及化学位移脉冲序列检查。
结果
以75毫秒的T2值为界值，回波平面成像对良性病变的敏感性为82%，特异性为96%。以肾上腺肿块与脾脏信号强度比0.80为界值，快速SE成像对良性病变的敏感性为53%，特异性为96%。以肾上腺肿块与脾脏比值0.55为界值，化学位移成像对良性病变的敏感性为80%，特异性为100%。
结论
化学位移成像以及从回波平面成像计算得出的T2值是鉴别肾上腺腺瘤与肾上腺恶性肿块的有前景的技术，并且可以避免活检。
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