評估磁振造影在腎細胞癌腫瘤定期之角色。臨床疑似罹患腎細胞癌之16位患者,在接受電腦斷層攝影檢查後,再接受磁振造影檢查。然後由二位放射線專科醫師判讀加以診斷和腫瘤定期後,再由泌尿外科醫師對患者進行根除性腎摘除。最後將電腦斷層攝影和磁振造影所見,各別和病理所見加以對照。磁振造影所見,由T1為主和T2為主之影像來偵測腎細胞癌不具特異性且不比電腦斷層攝影佳;但如注射順磁性顯影劑(釓-DPTA)可改善腎細胞癌之偵測率。磁振造影對腎細胞癌之腫瘤定期的準確率為93%比電腦斷層攝影對腎細胞癌之腫瘤定期的準確率80%佳。腎細胞癌之診斷和腫瘤定期應以電腦斷層攝影為主。而在特別之情況下才需要接受磁振造影,如電腦斷層攝影之結果不確定(如下腔靜脈侵犯或鄰近器官侵犯有爭論),病人無法接受含碘顯影劑(如腎衰竭或對含碘顯影劑有過敏之病史)。如果接受磁振造影除一般脈衝程序之掃描外,應另外施予注射顯影劑(釓-DPTA)之動態掃描及冠狀切面之檢查。
To evaluate the role of magnetic resonance imaging (MRI) in the tumor staging of renal cell carcinoma (RCC), MRI was carried out in 16 patients with clinical suspicion of RCC. Computed tomography (CT) was also carried out in the same 16. Interpretation of both their MRI and CT images to determine the tumor staging of RCC was carried out by two radiologists. Radical nephrectomy was the procedure subsequently used for 15 of the 16. Correlation between the imaging findings with the pathological findings was made for the 15. In the detection of RCC, MRI had no specificity and was equivalent to CT. But MRI, with its intravenous administration of paramagnetic substances (Gd-DPTA) could improve the detection rate of RCC. For accuracy of tumor staging, the MRI rate (93%) was better than that of CT (80%). In the tumor staging of RCC, CT is the first choice of possible examination techniques. In cases where there are equivocal results from CT examinations, or for patients who cannot accept intravenous administration of iodine-containing contrast media, MRI should be recommended.
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