Magnetic resonance imaging in the diagnosis of melanoma:: in vivo preliminary studies with dynamic contrast-enhanced subtraction
Magnetic resonance imaging in the diagnosis of melanoma:: in vivo preliminary studies with dynamic contrast-enhanced subtraction
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DOI：
10.1097/00008390-200208000-00009
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发表时间：
2002-08-01
影响因子：
2.2
通讯作者：
Falappa, P
中科院分区：
文献类型：
--
作者：
Pennasilico, GM;Arcuri, PP;Falappa, P
这项研究的目的是分析快速动态减影磁共振(MR)成像在区分体内黑色素瘤和良性黑素细胞病变方面的潜力。对18例黑素细胞皮损患者静脉注射吉多喷妥钠(GdDTPA)后进行动态磁共振成像。使用后处理算法，获得病变的时间-信号强度曲线，并根据其形状将其分为I型(稳定期增强)、II型(信号平台型)或III型(信号消失)。用于区分黑色素瘤和良性病变的其他参数包括Gd-DTPA注射后第一分钟的增强率(信号强度增加的百分比)、增强率的峰值和洗脱斜率。然后手术切除色素性病变，并将MR结果与组织学评估进行比较。黑色素瘤第一分钟的平均强化率为611%，良性病变为131%(P=0.001)。曲线类型的分布也不同：9例痣中有7例表现为I型曲线，而9例黑色素瘤中有8例表现为III型曲线。此外，还观察到了独特的褪色动力学：黑色素瘤的增强率在第一到第三分钟开始下降，但对于雀斑则持续增加到第六分钟(P=0.000)。这些发现很可能与黑色素瘤中出现的新生血管有关，表明动态磁共振成像有助于色素性皮肤病变的鉴别诊断。(C)2002年，里平科特·威廉姆斯·威尔金斯。
The aim of this study was to analyse the potential of fast dynamic subtraction magnetic resonance (MR) imaging in differentiating in vivo melanomas from benign melanocytic lesions. Dynamic MR imaging was performed after intravenous administration of gadopentetate dimeglumine (GdDTPA) in 18 patients with melanocytic skin lesions. Using a post-processing algorithm, time-signal intensity curves were obtained for the lesions and classified according to their shapes as type I (steady enhancement increase), type II (plateau of signal intensity) or type III (wash-out of signal intensity). Other parameters evaluated for their potential to differentiate melanomas from benign lesions were the enhancement rate (percentage of signal intensity increase) in the first minute after Gd-DTPA administration, the peak value of the enhancement rate, and the wash-out slope. The pigmented lesions were then surgically excised and the MR results compared with the histological assessment. In melanomas, the mean value of the enhancement rate in the first minute was 611%, whereas in benign lesions it was 131% (P=0.001). The distribution of curve types was also different: seven of the nine naevi showed type I curves, while eight of the nine melanomas displayed a type III curve. In addition, distinctive wash-out dynamics were observed: the enhancement rate began to decrease between the first and third minutes for melanomas, but continued to increase until the sixth minute for naevi (P=0.000). These findings, which are most likely related to the neoangiogenesis present in melanomas, indicate that dynamic MR imaging can be helpful in the differential diagnosis of pigmented skin lesions. (C) 2002 Lippincott Williams Wilkins.