Postema S, Pattynama P M, Bröker S, van der Geest R J, van Rijswijk C S, Baptist Trimbos J
Department of Radiology, Leiden University Medical Center, The Netherlands.
Clin Radiol. 1998 Oct;53(10):729-34. doi: 10.1016/s0009-9260(98)80314-0.
To quantify first-pass enhancement of cervix carcinoma using fast dynamic MRI. To assess the accuracy of dynamic contrast-enhanced colour-coded MRI for determining tumour invasion into surrounding pelvic tissues.
Gadolinium enhanced dynamic MRI at one image every 2 s was performed in 47 patients with cervical carcinoma and five controls. First-pass contrast enhancement of cervix carcinoma and surrounding pelvic tissues was quantified. Automated colour-coded images were constructed using the dynamic parameters slope, amplitude and timing of enhancement. Of 47 patients, 28 underwent surgery and colour coded images were correlated with histological findings.
First-pass contrast enhancement imaging of cervix carcinoma required a temporal resolution of dynamic MRI of one image every 3-4 s. Cervix carcinoma first-pass was more rapid and intense than that of other pelvic tissues (P<0.001) with the exception of normal myometrium (P>0.05). Binary colour coding, however, was not reliable for tumour delineation or for accurate assessment of tumour invasion into the parametria or the bladder wall. Overestimation of the extent of tumour invasion occurred in 15, 16 and nine out of 28 patients, respectively, using amplitude, slope and timing of enhancement as parameters.
Dynamic contrast-enhanced colour-coded MRI of cervix carcinoma has limited value for assessing the extent of tumour spread and tumour staging.
采用快速动态磁共振成像（MRI）对宫颈癌的首过强化进行定量分析。评估动态对比增强彩色编码MRI在确定肿瘤侵犯周围盆腔组织方面的准确性。
对47例宫颈癌患者和5例对照者进行钆增强动态MRI检查，每2秒采集一幅图像。对宫颈癌及周围盆腔组织的首过对比增强进行定量分析。利用增强的斜率、幅度和时间等动态参数构建自动彩色编码图像。47例患者中，28例接受了手术，将彩色编码图像与组织学结果进行关联分析。
宫颈癌的首过对比增强成像需要动态MRI的时间分辨率为每3 - 4秒采集一幅图像。宫颈癌的首过增强比其他盆腔组织更快、更强（P<0.001），正常子宫肌层除外（P>0.05）。然而，二元彩色编码在肿瘤勾画或准确评估肿瘤侵犯宫旁组织或膀胱壁方面并不可靠。以增强幅度、斜率和时间为参数，28例患者中分别有15例、16例和9例对肿瘤侵犯范围存在高估。
宫颈癌动态对比增强彩色编码MRI在评估肿瘤扩散范围和肿瘤分期方面价值有限。
