Staging of urinary bladder tumors by MRI:: Utility of intravesical administration of an iron oxide-containing contrast medium in combination with high-resolution, T2-weighted imaging.
Staging of urinary bladder tumors by MRI:: Utility of intravesical administration of an iron oxide-containing contrast medium in combination with high-resolution, T2-weighted imaging.
复制标题
DOI：
10.1055/s-2000-3751
复制
发表时间：
2000-06-01
影响因子：
1.8
通讯作者：
Hamm, B
中科院分区：
文献类型：
--
作者：
Beyersdorff, D;Taupitz, M;Hamm, B
目的：探讨超顺磁性氧化铁（SPIO）颗粒作为膀胱内应用的对比剂结合高分辨率T-2加权MR成像对膀胱肿瘤的诊断评估。研究方法：对40例疑似膀胱肿瘤的患者进行了前瞻性研究，这些患者使用1.5 T的体相阵列线圈进行了MR成像。成像前，将含SPIO的溶液（179.2 mg Fell）滴入膀胱。所有患者均采用T2加权、半傅立叶采集的单次激发快速自旋回波序列和T1加权快速低角度激发序列在3个平面上进行检查，以及使用512矩阵的T2加权快速自旋回波序列（TSE）。在33例患者中进行了额外的钆增强动态研究。所有患者均接受经尿道膀胱或膀胱肿瘤切除术。结果如下：膀胱内应用SPIO颗粒和高分辨率T2加权TSE序列的组合描绘了膀胱内肿瘤小至4 mm。仅5例中可以可靠识别膀胱壁的不同层。T2加权TSE序列通过评估膀胱壁的内外边界，可以正确确定36例尿路上皮癌患者中29例的浸润深度。该序列的诊断准确性为81%，而动态研究的诊断准确性为84%（26/31）。结论：即使是小的肿瘤，也可以在膀胱内施用SPIO颗粒后用T-2加权TSE序列识别，但不可能可靠地区分膀胱壁的层。结果表明，动态磁共振成像研究不能免除膀胱癌患者。
Aim: To investigate superparamagnetic iron oxide (SPIO) particles as intravesically applied contrast material in combination with high-resolution T-2-weighted MR imaging for the diagnostic assessment of urinary bladder tumors. Methods: A prospective study was performed in 40 patients with suspected urinary bladder tumors who underwent MR imaging with a body phased-array coil at 1.5 T. Prior to imaging, a SPIO-containing solution (179.2 mg Fell) was instilled into the bladder. All patients were examined with T-2-weighted, half-fourier acquired single shot turbo spin echo sequences and T-1-weighted fast low angle shot sequences in 3 planes as well as a T-2-weighted turbo spin echo sequence (TSE) using a 512 matrix. An additional gadolinium-enhanced dynamic study was performed in 33 patients. All patients underwent transurethral resection of the bladder or cystectomy. Results: The combination of intravesically applied SPIO particles and a high-resolution T2-weighted TSE sequence depicted intravesical tumors as small as 4 mm. A reliable identification of the different layers of the bladder wall was possible in 5 cases only. The T-2-weighted TSE sequence allowed the correct determination of the depth of infiltration in 29 of 36 patients with urothelial cancer by assessing the inner and outer boundary of the urinary bladder wall. This sequence had a diagnostic accuracy of 81% compared to 84% for the dynamic study (26/31). Conclusion: Even small tumors could be identified with the T-2-weighted TSE sequence after intravesical administration of SPIO particles but it was not possible to reliably differentiate the layers of the bladder wall. The results suggest that a dynamic MR imaging study cannot be dispensed with in patients with urinary bladder cancer.