Sardanelli F, Melani E, Sabattini R, Parodi R C, Castaldi A, Rescinito G, Mariani G, Luzzani M
Istituto di Radiologia, Università di Genova.
Radiol Med. 1997 Oct;94(4):296-301.
Magnetic resonance (MR) imaging showed high reliability in detecting spine metastases with spin-echo (SE) sequences, T1-weighted sequences being generally more sensitive than T/-weighted ones. We investigated the value of T2*-weighted gradient-echo (GE) sequences in studying spine metastases.
Twenty patients with established diagnosis of primary carcinoma and clinically suspected thoracic and/or lumbosacral spine metastases underwent .5-T MR imaging and 99mTc-HDP bone scan. The disagreement of GET2*- versus SET2-weighted images as well as versus bone scan and the disagreement of total MR results versus bone scan results were evaluated by McNemar test. The agreement of GET2*- versus SET1-weighted images was evaluated by Cohen's kappa.
Of a total of 111 MR signal abnormalities consistent with metastasis, 109 (98.2%) were T2*-hyperintense, whereas only 50 (45.1%) were T2-hyperintense (p < .0001) and 51 (45.9%) were detected with bone scan (p < .0001). Of a total of 121 MR and/or bone scan findings consistent with metastasis, 111 (91.7%) were MR positive, with high disagreement with 61 (50.4%) positive at bone scan (p < .00001). T2*-hyperintensity associated with T1-hypointensity (with or without T2-hyperintensity) was the most frequent pattern (104/111), 93.7%).
T2*-weighted GE sequences seem to be more effective than T2-weighted SE sequences and as effective as T1-weighted SE sequences. MR imaging confirms its ability in detecting abnormalities consistent with spine metastases.
磁共振(MR)成像在利用自旋回波(SE)序列检测脊柱转移瘤方面显示出高可靠性,T1加权序列通常比T2加权序列更敏感。我们研究了T2*加权梯度回波(GE)序列在研究脊柱转移瘤中的价值。
20例已确诊原发性癌且临床上怀疑有胸段和/或腰骶段脊柱转移瘤的患者接受了0.5-T MR成像和99mTc-HDP骨扫描。通过McNemar检验评估T2加权与T2加权图像之间以及与骨扫描之间的差异,以及总MR结果与骨扫描结果之间的差异。通过Cohen's kappa评估T2加权与T1加权图像之间的一致性。
在总共111个与转移瘤一致的MR信号异常中,109个(98.2%)为T2高信号,而只有50个(45.1%)为T2高信号(p <.0001),51个(45.9%)通过骨扫描检测到(p <.0001)。在总共121个与转移瘤一致的MR和/或骨扫描结果中,111个(91.7%)为MR阳性,与骨扫描中61个(50.4%)阳性存在高度差异(p <.00001)。与T1低信号相关的T2高信号(有或无T2高信号)是最常见的模式(104/111,93.7%)。
T2*加权GE序列似乎比T2加权SE序列更有效,且与T1加权SE序列效果相当。MR成像证实了其检测与脊柱转移瘤一致的异常的能力。