Hawighorst H, Knapstein P G, Schaeffer U, Brix G, Weikel P, Essig M, Zuna I, Knopp M V
Forschungsschwerpunkt Radiologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum, Heidelberg.
Radiologe. 1995 Dec;35(12):945-51.
The aim of the study was to evaluate the value of dynamic magnetic resonance imaging (MRI) to classify suspect lesions into benign and malignant in patients previously treated for cancer of the cervix.
Eleven patients with 14 suspect lesions after treatment of cervical carcinoma were examined by dynamic contrast-enhanced MRI. The imaging findings were compared to the giant cross-section specimen as the reference standard. Computed tissue-specific enhancement parameters were obtained (pharmacokinetic mapping) and displayed as color-coded images. The regions of interest were retrospectively defined according to the pharmacokinetic images over the most suspect areas. Therein, the threshold values were determined that achieved the greatest overall accuracy and a low rate of false-positive results.
Analysis of the lesions on T2-weighted images revealed sensitivity of 88%, specificity of 40%, and accuracy of 71%. Analysis of the dynamic MR data showed significantly shorter (p < 0.01) and stronger (p < 0.001) contrast media enhancement of malignant (n = 9) than benign lesions (n = 5).
Pharmacokinetic mapping appears to yield important information for dividing suspect lesions into malignant and benign following treatment of cervical cancer.
本研究旨在评估动态磁共振成像(MRI)在对先前接受过宫颈癌治疗的患者的可疑病变进行良恶性分类中的价值。
对11例宫颈癌治疗后有14个可疑病变的患者进行动态对比增强MRI检查。将成像结果与作为参考标准的巨大横截面标本进行比较。获取计算出的组织特异性增强参数(药代动力学图谱)并显示为彩色编码图像。根据药代动力学图像在最可疑区域回顾性定义感兴趣区域。在其中确定了能实现最高总体准确性和低假阳性率的阈值。
对T2加权图像上的病变分析显示,敏感性为88%,特异性为40%,准确性为71%。对动态MR数据的分析显示,恶性病变(n = 9)的对比剂增强明显短于(p < 0.01)且强于(p < 0.001)良性病变(n = 5)。
药代动力学图谱似乎为宫颈癌治疗后将可疑病变分为恶性和良性提供了重要信息。