Hawighorst H, Bock M, Knopp M V, Essig M, Schoenberg S O, Knapstein P G, Schad L R, van Kaick G
Department of Radiological Diagnostics and Therapy, German Cancer Research Center, Heidelberg.
Magn Reson Imaging. 1998 Apr;16(3):225-34. doi: 10.1016/s0730-725x(97)00297-x.
The aim of this pilot study was to evaluate a magnetically labeled water perfusion imaging technique as a non-contrast-enhanced approach to demonstrate the uterine artery, its branches, and to assess the cervical uterine blood flow in healthy volunteers and in patients with advanced uterine cervical carcinoma (FIGO IIB-IVA).
Seven healthy volunteers (mean age, 29 years) and twenty-two patients (mean age, 52 years) with advanced cancer of the uterine cervix (FIGO IIB-IVA) were prospectively examined by magnetically labeled water perfusion imaging at different inversion delay times (300-900 ms). The magnetic resonance imaging (MRI) findings of all patients were matched to the findings of contrast-enhanced dynamic MRI and multiple biopsies (n = 5) and/or surgical whole mount specimens (n = 17), which were available in all patients.
The uterine artery was well visualized with short inversion delay times of 300-500 ms. It was characterized as single or multiple helical loops before dividing into its intracervical branches. The intracervical branching was observed at inversion delay times of 500-700 ms. With longer inversion delay times, arterial signal enhancement disappeared and cervical tissue enhancement was noted. Enhancement of benign tissue was observed at inversion delay times of 1100-1700 ms and in malignant tissue at shorter inversion delay times of 900-1300 ms. The maximum of this diffuse signal enhancement of benign tissue was seen at inversion delay times of 1500 ms (1100-1700 ms) in malignant tissue at significantly (p < 0.5) shorter inversion delay times of 1100 ms (900-1300 ms).
Our preliminary results show that the vascular supply and blood flow of the normal uterine cervix and of advanced cervical cancer can be assessed by magnetically labeled water perfusion imaging and that malignant cervical tissue is earlier and stronger perfused than normal cervical tissue.
本初步研究的目的是评估一种磁性标记水灌注成像技术，作为一种非增强对比方法来显示子宫动脉及其分支，并评估健康志愿者和晚期子宫颈癌（国际妇产科联盟IIB-IVA期）患者的子宫颈血流情况。
对7名健康志愿者（平均年龄29岁）和22名晚期子宫颈癌（国际妇产科联盟IIB-IVA期）患者（平均年龄52岁）进行前瞻性研究，采用磁性标记水灌注成像在不同反转延迟时间（300-900毫秒）下进行检查。所有患者的磁共振成像（MRI）结果与增强对比动态MRI结果以及多次活检（n = 5）和/或手术全层标本（n = 17）结果进行匹配，所有患者均有这些资料。
在300-500毫秒的短反转延迟时间下，子宫动脉显示良好。其特征为在分成子宫颈内部分支之前为单个或多个螺旋环。在500-700毫秒的反转延迟时间下观察到子宫颈内分支。随着反转延迟时间延长，动脉信号增强消失，出现子宫颈组织增强。在1100-1700毫秒的反转延迟时间下观察到良性组织增强，在900-1300毫秒的较短反转延迟时间下观察到恶性组织增强。良性组织这种弥漫性信号增强的最大值出现在1500毫秒（1100-1700毫秒）的反转延迟时间，而恶性组织在明显较短的1100毫秒（900-1300毫秒）的反转延迟时间出现最大值（p < 0.5）。
我们的初步结果表明，磁性标记水灌注成像可用于评估正常子宫颈和晚期子宫颈癌的血管供应和血流情况，且恶性子宫颈组织的灌注比正常子宫颈组织更早且更强。
