Gückel C, Schnabel K, Deimling M, Steinbrich W
Department of Radiology, University Hospital of Basle, Switzerland.
Radiology. 1996 Sep;200(3):681-6. doi: 10.1148/radiology.200.3.8756914.
To evaluate the enhancement patterns of solitary pulmonary nodules (SPNs) with dynamic contrast-material-enhanced magnetic resonance (MR) imaging to differentiate between benign and malignant SPNs.
Twenty-eight patients with SPNs 30 mm or smaller in diameter were examined with pre- and postcontrast, electrocardiographically gated, T1-weighted spin-echo (SE) sequences and a snapshot gradient-echo (GRE) sequence after bolus injection of a paramagnetic contrast agent. For all SPNs (20 malignant, eight benign), the percentage increase in signal intensity (%SI) on the postcontrast T1-weighted SE images and the enhancement curves (%SI/sec) for the snapshot GRE measurements were established from regions of interest.
Malignant nodules showed a higher increase of signal intensity during the first transit of the bolus of contrast material on the dynamic snapshot GRE images (malignant: median, 18.1 %SI/sec; range, 6.7-95.2 %SI/sec; benign: median, 2.3 %SI/sec; range, 0.1-8.1 %SI/sec) (P < .0001). Static T1-weighted SE measurements did not allow differentiation between malignant (median, 53.4 %SI; range 12.5-110.0 %SI) and benign (median, 33 %SI; range, 0.8-85.5 %SI) (P > .2) nodules on the basis of the degree of contrast enhancement.
Dynamic contrast-enhanced MR measurements of tumor enhancement can provide additional information about the nature of SPNs.
通过动态对比剂增强磁共振（MR）成像评估孤立性肺结节（SPN）的强化模式，以鉴别良恶性SPN。
对28例直径30 mm或更小的SPN患者，在静脉注射顺磁性对比剂前后，采用心电门控的T1加权自旋回波（SE）序列及快速扰相梯度回波（GRE）序列进行检查。对于所有SPN（20个恶性，8个良性），在对比剂增强后的T1加权SE图像上确定感兴趣区的信号强度增加百分比（%SI），并建立快速GRE测量的强化曲线（%SI/秒）。
在动态快速GRE图像上，恶性结节在对比剂首次通过时信号强度增加更高（恶性：中位数，18.1 %SI/秒；范围，6.7 - 95.2 %SI/秒；良性：中位数，2.3 %SI/秒；范围，0.1 - 8.1 %SI/秒）（P <.0001）。基于对比剂强化程度，静态T1加权SE测量无法区分恶性（中位数，53.4 %SI；范围12.5 - 110.0 %SI）和良性（中位数，33 %SI；范围，0.8 - 85.5 %SI）结节（P >.2）。
肿瘤强化的动态对比增强MR测量可为SPN的性质提供额外信息。
