MAGNETIC-RESONANCE IMAGING OF MEDIASTINAL AND HILAR MASSES - COMPARISON WITH CT
MAGNETIC-RESONANCE IMAGING OF MEDIASTINAL AND HILAR MASSES - COMPARISON WITH CT
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DOI：
10.2214/ajr.145.1.9
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发表时间：
1985-01-01
影响因子：
5
通讯作者：
MURPHY, WA
中科院分区：
文献类型：
--
作者：
LEVITT, RG;GLAZER, HS;MURPHY, WA
本文对37例支气管肺癌（其中35例不能手术切除）和11例其他肿块的纵隔和（或）肺门的磁共振成像（MRI）和计算机断层扫描（CT）进行了比较。使用短脉冲重复率（TR）和短回波延迟（TE）的自旋回波脉冲序列最有助于检测纵隔和肺门的异常软组织肿块。MRI和CT对支气管肺癌根治性可切除性/不可切除性分期的准确性相当。CT对37例中的35例进行了适当的分期，而MRI对37例中的36例进行了正确的分期。MRI评价纵隔的几个缺陷被确定。除非进行连续扫描，否则MRI可能会将食管误解为气管后淋巴结肿大。MRI无法检测到因陈旧性肉芽肿性疾病而导致的扩大的纵膈和肺门淋巴结中的散在钙化。CT单独显示的邻近小淋巴结可能由于部分体积平均而在MRI中表现为单个肿大淋巴结。由于呼吸运动和部分体积平均，MRI可能无法检测到小的肺结节。有些病人不适合做MR扫描。由于对患者选择的要求和MRI的缺陷，CT仍然是目前支气管肺癌患者分期和其他纵隔和肺门肿块评估的首选放射学方法。然而，由于MRI能够在没有血管内造影剂的情况下显示血管，因此在评估具有潜在造影剂过敏的患者和解决CT无法解决的诊断问题方面非常有用。
Magnetic resonance imaging (MRI) was compared to computed tomography (CT) of the mediastinum and/or hila in 37 patients with bronchogenic carcinoma (35 unresectable for cure) and 11 patients with other masses. Spin-echo pulse sequences using a short pulse repetition rate (TR) and short echo delay (TE) were most helpful for detection of abnormal soft-tissue mediastinal and hilar masses. The accuracy of MRI and CT in staging bronchogenic carcinoma for curative resectability/nonresectability was comparable. CT staged 35 of 37 cases appropriately, while MRI correctly staged 36 of 37 cases. Several pitfalls in MRI evaluation of the mediastinum were identified. By MRI the esophagus may be misinterpreted as an enlarged retrotracheal lymph node unless serial scans are studied. Scattered calcifications in enlarged mediastinal and hilar lymph nodes due to old granulomatous disease are not detectable by MRI. Small adjacent lymph nodes shown individually by CT may appear as a single enlarged lymph node by MRI due to partial-volume averaging. Small lung nodules may be undetected by MRI due to respiratory motion and partial-volume averaging. Certain patients are unsuitable for MR scanning. Because of the requirement for patient selection and the identified pitfalls of MRI, CT remains the radiologic procedure of choice in the staging of patients with bronchogenic carcinoma and the evaluation of other mediastinal and hilar masses at present. However, because of the ability to show blood vessels without an intravascular contrast agent, MRI is useful in evaluating patients with potential contrast allergy and solving diagnostic problems not solved by CT.