Inui K, Nakazawa S, Yoshino J, Yamao K, Yamachika H, Wakabayashi T, Kanemaki N, Hidano H
Department of Internal Medicine, Second Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
Endoscopy. 1995 Sep;27(7):480-5. doi: 10.1055/s-2007-1005752.
The principle of endoscopic ultrasonography--introducing the transducer of an external imaging method, such as ultrasonography, in combination with an endoscope into the gastrointestinal tract for higher-resolution imaging--has also been applied to magnetic resonance imaging (MRI). We report here on our preliminary experience with a new method of endoscopic MRI in the upper gastrointestinal tract.
Endoscopic MRI was performed in 32 patients with esophageal (n = 8) or gastric diseases (n = 24), mostly tumors (n = 26). Most cancers were at an advanced stage (T3/T4). A prototype MRI endoscope connected to a 1.5 tesla MRI scanner was used. The accuracy of endoscopic MRI in visualizing and staging gastrointestinal lesions was assessed.
The normal gastrointestinal wall consisted of three layers, and tumors were visualized as having a low signal intensity on both T1- and T2-weighted sequences. Destruction of the wall layers was found to be characteristic of malignancy. Sufficient images were obtained in seven of eight esophageal cases (88%), but in only 14 of 24 gastric cases (58%). In patients in whom adequate visualization was achieved, the endoscopic MRI results of local and regional staging were consistent with surgical, histopathological, CT and/or EUS results in all six esophageal cancer cases and in 89% (T stage) and 56% (N stage) of the nine patients with gastric cancer.
These preliminary results of endoscopic MRI are the first to be reported in the English literature. They show the potential of the method for local and regional staging, three-dimensional visualization of lesions being a potential advantage. Further technical improvements are expected.
内镜超声检查的原理——将外部成像方法（如超声检查）的换能器与内镜相结合引入胃肠道以获得更高分辨率的成像——也已应用于磁共振成像（MRI）。我们在此报告我们在上消化道内镜MRI新方法方面的初步经验。
对32例患有食管疾病（n = 8）或胃部疾病（n = 24）的患者进行了内镜MRI检查，其中大多数为肿瘤（n = 26）。大多数癌症处于晚期（T3/T4）。使用了连接到1.5特斯拉MRI扫描仪的原型MRI内镜。评估了内镜MRI在观察和分期胃肠道病变方面的准确性。
正常胃肠道壁由三层组成，肿瘤在T1加权和T2加权序列上均表现为低信号强度。壁层破坏被发现是恶性肿瘤的特征。8例食管病例中有7例（88%）获得了足够的图像，但24例胃部病例中只有14例（58%）。在获得充分可视化的患者中，6例食管癌患者以及9例胃癌患者中的89%（T分期）和56%（N分期）的内镜MRI局部和区域分期结果与手术、组织病理学、CT和/或EUS结果一致。
这些内镜MRI的初步结果是英文文献中首次报道的。它们显示了该方法在局部和区域分期方面的潜力，病变的三维可视化是一个潜在优势。预计会有进一步的技术改进。
