MRI 是偵測骨癌轉移最好的方法


  2003 年5月7日-根據一項在5月7 日於聖地牙哥所舉行的美國放射學會年會中所提出的比較性試驗結果,磁共振影像(MRI)比閃爍錄像術或正子放射型電腦斷層攝影(PET)更適合進行骨癌轉移的整體檢測。
  
  主要作者德國Freiburg大學醫院的Nadir Ghanem博士表示,全身MRI使用在預測併發症上是相當卓越的,例如骨折。使用滾動式平臺,或沖浪板式的平台,也可以使患者在較短的時間內從頭到腳進行掃描。
  
  在98名研究患者中的40名患者,全身MRI和骨骼掃瞄都檢測出骨骼變形的疾病,而在這些患者中的21名患者,MRI顯示出更廣泛的疾病。相較於MRI,骨骼掃瞄在六名患者中顯示出更廣泛的胳膊、腿,和肋骨的疾病,MRI檢測出11個骨骼掃描為陰性病例的骨癌轉移。
  
  在進行研究的98名患者中,有80名患者經由MRI發現初期腫瘤、淋巴結侵入,和內臟及軟組織的轉移。
  
  在98名患者中,45名進行全身FDG-PET,包括19名患者經過MRI 和PET檢測出現陰性反應,10名經由MRI和PET檢測發現骨癌轉移為陽性。在10名骨癌轉移的7名患者中,MRI顯示出更廣泛的病情轉移。
  
  在6名二種結果不一致的患者中,5位患者以MRI檢測為陽性,以PET檢測為陰性。最後經由臨床檢查證實了MRI的陽性結果。
  
  MRI技術的好處是,只需10分鐘的時間就可以得到結果,但是骨骼掃描卻需要等待15到20分鐘的時間,而PET則需要90分鐘之久。不同於骨骼掃瞄和PET,MRI 不需要使用輻射或對比物質。
  
  這項特殊的研究包含98名患者,但是我們已經利用MRI進行了超過250名患者的全身檢查,同時也與滾輪式平臺進行結合。
  

MRI Best for Whole Body Detect

By Laurie Barclay, MD
Medscape Medical News

May 7, 2003 — Magnetic resonance imaging (MRI) was better than scintigraphy or positron emission tomography (PET) for whole body detection of skeletal metastases, according to the results of a comparison trial presented on May 7 during the American Roentgen Ray Society annual meeting in San Diego, California.

"Whole body MR imaging was outstanding in predicting possible complications, such as fractures," lead author Nadir Ghanem, MD, from University Hospital Freiburg in Germany, says in a news release.

Using a rolling table platform, or "bodysurf," allowing a broader view, patients could be imaged nearly head to toe in a relatively short time.

In 40 of 98 patients studied, both whole body MRI and a bone scan detected skeletal metastatic disease. In 21 of these patients, MRI revealed more extensive disease than did bone scans. Compared with MRI, the bone scan showed more extensive disease in the arms, legs, and ribs in six patients. MRI detected skeletal metastases in 11 cases with negative bone scans.

In 80 of the 98 patients studied, MRI "yielded additional morphological information about the primary tumor, lymph node involvement, and visceral and soft tissue metastases," Dr. Ghanem says.

Of the 98 patients, 45 had whole-body FDG-PET, including 19 patients with negative MRI and PET, and 10 in whom both MRI and PET were positive for skeletal metastases. In seven of the 10 patients with skeletal metastases, MRI revealed more extensive metastatic disease.

In six patients with discordant findings using the two techniques, five had positive MRI and negative PET. The positive MRI findings were confirmed by clinical follow-up.

Advantages of this MRI technique are that it takes less than 10 minutes, compared with 15 to 20 minutes for bone scans and 90 minutes for PET scans. Unlike bone scans and PET, which both require the use of a radioisotope, the MRI uses no radiation or contrast media.

"This particular study included 98 patients, but we have done more than 250 investigations using whole body MR imaging combined with a rolling table platform," Dr. Ghanem says.

ARRS 103rd Annual Meeting: Abstract 203. Presented May 7, 2003.

Reviewed by Gary D. Vogin, MD

    
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