Barkhof F, Smeets M, van der Valk P, Tan K E, Hoogenraad F, Peeters J, Valk J
Department of Diagnostic Radiology, Free University Hospital, P. O. Box 7057, NL-1007 MB Amsterdam, The Netherlands.
Eur Radiol. 1997;7(5):726-31. doi: 10.1007/BF02742934.
We studied the appearance of retinoblastoma on unenhanced and gadolinium-enhanced images and the accuracy of tumour staging with MR imaging. The MR images were obtained in 18 children with retinoblastoma and compared with histopathological findings after enucleation. The MR imaging included T1-weighted and dual-echo T2-weighted images before, and T1-weighted images after, gadopentetate dimeglumine injection. The contrast between tumour and ipsilateral vitreous strongly increased (57 %) after gadolinium on T1-weighted images (p = 0.004). Tumour was strongly hypointense as compared with ipsilateral vitreous in all patients using heavily T2-weighted (TE = 120 ms) images (p = 0.001). The estimated T2 of tumour (mean 96 + 14 ms) did not correlate with histological grading or degree of calcification. Unenhanced T1-weighted MR images rightfully excluded extrascleral growth in 16 of 16 cases, but its presence was confirmed after enucleation in only one of 2 abnormal MR scans. Invasion of the optic nerve behind the cribriform plate was confirmed in 2 of 3 abnormal gadolinium-enhanced MR scans, but also in 1 of the 15 cases in which MR images were normal. The T2-weighted images were useful in assessing retinal detachment. We conclude that heavily T2-weighted images, unenhanced T1-weighted images and gadolinium-enhanced T1-weighted MR images are complementary in characterizing and staging retinoblastoma.
我们研究了视网膜母细胞瘤在平扫及钆增强图像上的表现以及磁共振成像（MR）对肿瘤分期的准确性。对18例视网膜母细胞瘤患儿进行了MR成像，并与眼球摘除术后的组织病理学结果进行比较。MR成像包括钆喷酸葡胺注射前的T1加权像和双回波T2加权像，以及注射后的T1加权像。钆增强后，T1加权像上肿瘤与同侧玻璃体之间的对比度显著增加（57%）（p = 0.004）。在所有患者中，使用重T2加权（TE = 120 ms）图像时，肿瘤与同侧玻璃体相比呈明显低信号（p = 0.001）。肿瘤的估计T2值（平均96 + 14 ms）与组织学分级或钙化程度无关。平扫T1加权MR图像在16例中的16例正确排除了巩膜外生长，但在2例异常MR扫描中，仅1例在眼球摘除术后证实有巩膜外生长。在3例异常钆增强MR扫描中有2例证实筛板后视神经受侵，但在15例MR图像正常的病例中也有1例受侵。T2加权图像有助于评估视网膜脱离。我们得出结论，重T2加权图像、平扫T1加权图像和钆增强T1加权MR图像在视网膜母细胞瘤的特征性描述和分期方面具有互补性。
