Small (<2-cm) upper-tract urothelial carcinoma: evaluation with gadolinium-enhanced three-dimensional spoiled gradient-recalled echo MR urography.
Small (<2-cm) upper-tract urothelial carcinoma: evaluation with gadolinium-enhanced three-dimensional spoiled gradient-recalled echo MR urography.
复制标题
小（<2厘米）上尿路尿路上皮癌：用钆增强三维破坏梯度回忆回声MR尿路造影进行评估。
DOI：
10.1148/radiol.2472070798
复制
发表时间：
2008
期刊：
影响因子：
19.7
通讯作者：
B. King
中科院分区：
文献类型：
--
作者：
N. Takahashi;A. Kawashima;J. Glockner;R. Hartman;B. Leibovich;A. Brau;P. Beatty;B. King
目的
回顾性评价钆增强三维（3D）扰相梯度回波（GRE）磁共振（MR）尿路造影对小（<2 cm）尿路上皮肿瘤的检出。
材料和方法
这项符合HIPAA的研究获得了机构审查委员会的批准。所有纳入研究的患者之前都同意将其医疗记录用于研究目的。110例患者（10例男性，1例女性;平均年龄73.5岁）接受MR尿路造影检查，最终确定有23个小于2 cm的上尿路上皮癌或原位癌。所有患者均使用1.5 T成像仪在静脉注射钆基造影剂后，在肾造影和排泄期获得屏气冠状面T2加权单次激发快速自旋回波和屏气冠状面3D T1加权破坏GRE图像，并进行脂肪抑制。两名放射科医生一致审查了MR图像，以确定是否存在肿瘤。通过使用McNemar检验比较每个序列之间的病变可检测性。
结果
在23个肿瘤中，17个（74%）通过使用至少一个序列检测到，8个（35%）通过T2加权成像检测到，15个（65%）通过肾造影相图像检测到，15个（65%）通过排泄相图像检测到。两个病变，每个只检测到无论是肾造影或排泄期图像。肾造影和排泄期图像的检出率明显高于T2加权图像（P <0.05）。
结论
钆增强3D破坏GRE MR尿路造影有助于发现74%的小尿路上皮癌。肾造影和排泄期图像对于帮助发现小尿路上皮癌是必不可少的。
PURPOSE
To retrospectively evaluate the detection of small (<2-cm) urothelial tumors by using gadolinium-enhanced three-dimensional (3D) spoiled gradient-recalled echo (GRE) magnetic resonance (MR) urography.
MATERIALS AND METHODS
This HIPAA-compliant study received institutional review board approval. All patients included had previously consented to the use of their medical records for research purposes. Eleven of 110 patients (10 men, one woman; mean age, 73.5 years) who underwent MR urography were ultimately identified to have 23 upper-tract urothelial carcinomas smaller than 2 cm or carcinoma in situ. Breath-hold coronal T2-weighted single-shot fast spin-echo and breath-hold coronal 3D T1-weighted spoiled GRE images with fat suppression during nephrographic and excretory phases after intravenous injection of gadolinium-based contrast material were obtained in all patients with a 1.5-T imager. Two radiologists reviewed the MR images in consensus for the presence of tumors. Lesion detectability was compared between each sequence by using the McNemar test.
RESULTS
Of 23 tumors, 17 (74%) were detected by using at least one sequence, eight (35%) were detected with T2-weighted imaging, 15 (65%) were detected on nephrographic phase images, and 15 (65%) were detected on excretory phase images. Two lesions each were detected only on either nephrographic or excretory phase images. Detectability was significantly higher on nephrographic and excretory phase images compared with T2-weighted images (P < .05).
CONCLUSION
Gadolinium-enhanced 3D spoiled GRE MR urography helped detect 74% of small urothelial carcinomas. Nephrographic and excretory phase images are essential for helping detect small urothelial carcinomas.