Kacl G M, Bicik I, Schönenberger A W, Steiner P, Romanowski B, Debatin J F, von Schulthess G K
Department of Medical Radiology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland.
Eur Radiol. 1998;8(7):1173-8. doi: 10.1007/s003300050529.
The aim of this study was to demonstrate the clinical feasibility and utility of an interactive MR-guidance system to target and biopsy thyroid lesions, and to compare resolution between ultrasound and interventional MR imaging in the evaluation of thyroid lesions. Twenty thyroid lesions of 18 patients were interactively biopsied using a 0.5-T superconducting open magnet system. Stereotactic localization of the needle and imaging was accomplished using T1-weighted gradient-recalled-echo (GRE) images. Representative cytological material was retrieved in 16 of 20 lesions (benign cystic or colloid goiter: n = 14; one de Quervain's thyroiditis and one follicular neoplasia). Lesions smaller than 1.5 cm detected by ultrasound could not be visualized adequately on GRE images. Lesions smaller than 1.5 cm were successfully biopsied by ultrasound (three colloid and haemorrhagic goiters and one adenoma). Magnetic-resonance-guided interactive biopsies and positioning of non-ferromagnetic needles in the thyroid gland are technically feasible and safe. Compared with high-resolution ultrasound, lesions larger than 1.5 cm can be adequately visualized and biopsied. Magnetic-resonance-guided placement of non-ferromagnetic needles is no substitute for high-resolution ultrasound in clinical work-up of thyroid lesions.
本研究的目的是证明交互式磁共振引导系统用于甲状腺病变靶向活检的临床可行性和实用性，并比较超声和介入性磁共振成像在评估甲状腺病变时的分辨率。使用0.5-T超导开放式磁体系统对18例患者的20个甲状腺病变进行交互式活检。使用T1加权梯度回波（GRE）图像完成针的立体定向定位和成像。在20个病变中的16个中获取了代表性的细胞学材料（良性囊肿或胶样甲状腺肿：n = 14；1例亚急性甲状腺炎和1例滤泡性腺瘤）。超声检测到的小于1.5 cm的病变在GRE图像上无法充分显示。小于1.5 cm的病变通过超声成功进行了活检（3例胶样和出血性甲状腺肿及1例腺瘤）。磁共振引导的交互式活检以及在甲状腺中放置非铁磁性针在技术上是可行且安全的。与高分辨率超声相比，大于1.5 cm的病变能够被充分显示并进行活检。在甲状腺病变的临床检查中，磁共振引导的非铁磁性针放置不能替代高分辨率超声。
