Staging of malignant pleural mesothelioma: Comparison of CT and MR imaging
Staging of malignant pleural mesothelioma: Comparison of CT and MR imaging
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DOI：
10.2214/ajr.172.4.10587144
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发表时间：
1999-04-01
影响因子：
5
通讯作者：
Eisen, C
中科院分区：
文献类型：
--
作者：
Heelan, RT;Rusch, VW;Eisen, C
客观的。本文比较了CT与MR成像对恶性胸膜间皮瘤分期的准确性、对象和方法。 95 名患者参加了基于国际间皮瘤兴趣小组分期系统的前瞻性分期方案。 65 名患者接受了 CT 和 MR 成像以及外科手术（不包括经皮穿刺活检）以分期和切除肿瘤。进行了接收器操作特性分析。 CT 和 MR 扫描由不知道其他影像学研究结果的观察者独立解释；将这些影像学检查结果与手术及病理检查结果进行比较。结果。成像显示的 10 个特征中的 8 个特征的受试者工作特征曲线下面积显示 CT 和 MR 成像之间没有统计学上的显着差异。然而，MR 成像在显示膈肌侵犯方面（CT 的 A(z) = 0.55，MR 成像的 A(z) = 0.82）和显示胸内筋膜的侵犯或胸壁侵犯的孤立性可切除病灶（CT 的 A(z) = 0.46；MR 成像的 A(z) = 0.69）优于 CT。由于手术中的阳性结果很少见，因此无法评估几个解剖区域。结论。 CT 和 MR 成像在恶性胸膜间皮瘤分期方面具有几乎相同的诊断准确性。 MR 成像在显示胸壁侵犯和胸内筋膜受累的孤立病灶以及显示膈肌侵犯方面优于 CT；不过，这一优势并不影响手术治疗。出于成本原因，CT 应被视为治疗前的标准诊断研究。
OBJECTIVE. This article compares the accuracy of CT with that of MR imaging in staging of malignant pleural mesothelioma,SUBJECTS AND METHODS. Ninety-five patients were enrolled in a prospective staging protocol based on the International Mesothelioma Interest Group staging system. Sixty-five patients underwent CT and MR imaging and a surgical procedure (excluding percutaneous needle biopsy) to stage and resect the tumor. Receiver operating characteristic analyses were performed. CT and MR scans were interpreted independently by observers who were unaware of the results of the other imaging study; these imaging findings were compared with the results of surgery and pathologic examination,RESULTS. The areas under the receiver operating characteristic curves for eight of 10 features revealed by imaging showed no statistically significant differences between CT and MR imaging. However, MR imaging was superior to CT in revealing invasion of the diaphragm (A(z) = .55 for CT versus .82 for MR imaging) and in revealing invasion of endothoracic fascia or solitary resectable foci of chest wall invasion (A(z) = .46 for CT; A(z) = .69 for MR imaging). Several anatomic regions could not be evaluated because positive findings at surgery were rare.CONCLUSION. CT and MR imaging are of nearly equivalent diagnostic accuracy in staging malignant pleural mesothelioma. MR imaging is superior to CT in revealing solitary foci of chest wall invasion and endothoracic fascia involvement and in showing diaphragmatic muscle invasion; however, this advantage does not affect surgical treatment. For cost reasons, CT should be considered the standard diagnostic study before therapy.