- 期刊
不同磁振造影波序於尤文氏肉瘤患者之效果比較－術後追蹤病例報告
The Effects of Different Magnetic Resonance Sequence on Patients with Ewing's Sarcoma -Postoperative Follow-up Case Report
摘要
尤文氏肉瘤（Ewing's sarcoma）此病僅次於骨肉瘤（Osteosarcoma）為小孩及青少年原發性骨骼癌症第二常見的疾病。此一疾病好發於長骨的骨幹，在治療上因使用金屬植入物對受影響的骨頭的部件進行更換，以防止病灶擴散到其他健康組織。所以在每年追蹤的常規影像上常會因金屬假影干擾，影響開刀部位是否再次復發的判讀準確率。所以在MRI的影像診斷上，需盡可能減少金屬假影開刀部位產生的影響，雖然不同成像波序有不同的診斷價值，但病患常伴隨疼痛無法配合太久，故選擇一個適當的成像波序就非常重要。本案例主要藉由使用T1 權重、T1 權重加脂肪壓抑、STIR (Short TI inversion recovery)短反轉時間反轉回復與MAVRIC (Multi-Acquisition with Variable Resonance Image Combination Selective)多採集與可變諧影像結合等不同磁振造影波序，比較尤文式肉瘤在金屬植入物術後的追蹤影像。MAVRIC 使用非選擇性頻率，即以離散頻率偏移獲取多個重疊體積激發脈衝後再加上切面選擇方向使用多個不同的View Angle Tilting 技術讀出訊號，再藉由電腦後重組，將影像去模糊化，以除掉金屬假影，有助於消除影像上的失真與假影。在打藥後的影像已經改善在MR 影像中金屬植入物附近的骨骼和軟組織的假影產生，並產生高價值診斷的MR 影像。
並列摘要
Ewing sarcoma is primary bone cancer and second only to osteosarcoma for children and adolescents. It often occurs in the long bone, and uses of metal implants replace the parts as affected bones to prevent spread to other healthy tissues. In the annual follow-up of conventional MRI scanning, it will have metal artifacts to interfere with the re-examination recurrence of the surgical site. Although the different imaging sequence have varied diagnostic values, the patients often accompanied by pain cannot for long examination time. So how to choose a suitable imaging sequence is very important. In our case, we use T1 weight, T1 weight plus fat suppression, short tau reversal recovery (STIR) and Multi-Acquisition with Variable Resonance Image Combination Selective (MAVRIC) and other different magnetic resonance imaging sequence, and compared image quality on Ewing sarcoma with metal implantation. MAVRIC uses a non-selective frequency method; discrete frequency offsets to obtain multiple overlapping volumetric excitation pulses and then plus a slice selection direction using multiple different view angle tilting techniques. The image is de-blurred to remove the metal artifacts that help to eliminate the distortion of the image and artifacts. It has been improved the artifacts of the metal implants near the bones and soft tissue and produced high value diagnostic MR images.
延伸閱讀
- 陳緯遠、陳建誠、廖大富、黃耀祥、蔡惠予、黃怡璇（2017）。術中使用移動式電腦斷層掃描儀執行腦部血管攝影評估動脈瘤夾除術後之成效－案例報告。中華放射線技術學雜誌，41(3)，145-150。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201709-201710190004-201710190004-145-150
- 潘冠碩（2020）。【論文摘要】早期物理治療介入對手術後的腦膜瘤病人功能恢復之成效：個案報告。物理治療，45(2)，164-165。https://doi.org/10.6215/FJPT.202006.P38
- 洪瑞助、李正輝、盧建利、陳良光、呂坤木、蘇誠道（2004）。以充氣式磁振攝影評估大腸癌之局部擴散－病例報告。中華放射線技術學雜誌，28(2)，169-174。https://doi.org/10.30045/CJRT.200412.0007
- Sakabe, T., Murata, H., Konishi, E., Koto, K., Horie, N., Matsui, T., Sawai, Y., Yamazaki, H., Kagiya, T. V., & Kubo, T. (2011). High Efficacy of Preoperative Low-Dose Radiotherapy with Sanazole (AK-2123) for Extraskeletal Ewing’s Sarcoma: A Case Report. Sarcoma, 2011(), 27-32. https://doi.org/10.1155/2011/185465
- GEEL, A. N. V., EGGERMONT, A. M., HANSSENS, P. E. J., & SCHMITZ, P. I. M. (2003). Factors influencing prognosis after initial inadequate excision (IIE) for soft tissue sarcoma. Sarcoma, 2003(), 159-165. https://doi.org/10.1080/13577140310001650321