The Diagnosis of Bladder Carcinoma on Low Field of MRI<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
唐桂波 刘智明
青海省人民医院影像科泌尿科 西宁 810007
Gui-bo Tang Zhi-ming Liu
Qinghai Provincial People's Hospital, Xining 810007
Abstract
Objective:To invetigate the practical value of low field of MRI in the preoperative staging and diagnosis of bladder carcinoma.
Method:MRI was performed in 49 cases which are suspected of bladder carcinoma.All cases were confirmed histological-ly.
Result:Among the 49 cases of bladder Carcinoma, 38 cases of intra-cavity type, 7cases of infiltrating type, 4 ases of extra-cavity type were detected by MRI with accuracy of 93.9%. Agreement in staging of preoperative MRI and pathology was found in 83.7%.
Conclusion:MRI has significant practical value in detecting, locating and staging bladder carcinoma.
Key words:Bladder, Carcinoma, Staging, MRI
膀胱癌是泌尿系统最常见的恶性肿瘤。其术前诊断及分期,对于治疗方案的选择非常重要。现将我院于1996.5~2003.12经MRI诊断、手术病理证实的49例总结报道如下。
材料与方法
一、一般资料
本组49例,均为我院住院病人,男38例,女11例,年龄36~76岁,平均67.2岁。49例均术前做MRI检查并经手术病理证实。其中原发性膀胱癌40例,复发癌9例。
二、检查方法
1. MR扫描:
用西门子公司生产的开放式0.2T常导型磁共振成像仪。患者扫描前适度充盈膀胱,无需其他准备。采用体部线圈,常规行SE序列横轴位和矢状位T1WI和T2WI,必要时行冠状位T1WI。T1WI TR 680ms,TE 15ms ,T2WI TR 3362ms,TE 102ms,层厚6mm,层距2mm,FOV350×350mm。
2. MRI增强:
用国产磁显葡胺,0.1mmol/Kg体重。静脉注射后即刻行横轴位T1WI扫描。
3. 磁共振水成像:
本组20例因肿瘤侵及输尿管引起尿路积水行MRI尿路造影检查(MRU)。常规扫描完成后,在膀胱充盈条件下,平静呼吸,由冠状位T1WI确定扫描部位,包括肾、输尿管和膀胱。采用单次激发快速自旋回波技术(FSE),重T2WI,2D数据采集成像,TR2800ms,TE1100ms,矩阵256×240,FOV320×320mm层厚10mm,无间距扫描。将所得的原始图像在工作站行3D最大信号强度投影(MIP)重建,得到3D尿路造影图像,再选择30°角进行3D立体旋转,得到30°角旋转图像。 |