The role of magnetic resonance imaging in early detection of recurrent breast cancer

Purpose

The purpose of this work was the evaluation of new advances of magnetic resonance imaging (MRI) in diagnosis of recurrent breast cancer after conservative surgery, chemotherapy and radiotherapy.

Surgery for recurrent rectal carcinoma: The role of preoperative magnetic resonance imaging

Despite apparent curative resection of rectal carcinoma, local recurrence rates of between 3 and 32% have been reported. For those patients, radical surgical resection offers the only hope of cure. We present a review of the magnetic resonance imaging (MRI) findings and contraindications to curative surgery demonstrated using imaging.     

高场强MRI在胃癌术后复发诊断中的应用价值

目的 探讨高场强MRI在胃癌术后复发诊断中的应用价值及临床意义。方法 选择胃癌术后患者43例。其中,胃癌术后复发组33例,均经过消化道钡餐、CT、手术或胃镜活检和病理检查确诊;对照组10例,均经胃镜活检及病理检查证实无复发。MRI检查前使用低张剂,服用水做为阴性对比剂,应用1.5TMR快速扰相梯度回波序列、快速恢复自旋回波序列、扩散加权成像、真稳态进动快速序列等及动态增强扫描检查方法。结果 MRI诊出胃癌术后复发患者30例。对照组残胃壁厚度(4.5±0.3) mm,吻合口胃壁厚度(6.3±1.4) mm;复发组残胃吻合口胃壁增厚>8mm者30例,吻合口邻近胃壁厚度>5 mm者19例,吻合口软组织肿块并邻近胃壁增厚者11例,肝脾胰腺等周围脏器转移者5例,肝胃之间、腹腔、腹膜后淋巴结转移者9例,病灶在动脉期不均匀强化者9例,静脉期及平衡期病灶呈渐进性、延迟强化者30例。结论 MRI较好地显示了残胃壁及吻合口胃壁的厚度,能够准确判断肿瘤浸润深度、是否与周围组织有毗邻关系以及是否有淋巴结和腹腔内脏器转移等,可以用来指导临床手术方案的选择或综合治疗,对提高胃癌术后生存率具有重要的临床意义。     

高场强MRI在胃癌术后复发诊断中的应用价值

Objective To evaluate the clinical application of high-field-strength magnetic resonance imaging to diagnose recurrent gastric cancer. Methods Forty three postoperative patients with gastric carcinoma were divided into two groups. The group with recurrent gastric carcinoma has 33 patients, they were clinically confirmed by barium meal of alimentary canal, CT or pathological results. There were 10 cases in control group confirmed by pathological results. All the subjects took hypotonicity agent, followed by water as negative contrast medium. Then patients underwent magnetic resonance imaging including fast spoiled gradient recalled T1WI, T2WI, diffusion weighted imaging, fast imaging employing steady state sequence, magnetic resonance cholangiopancreatographyand dynamic contrast enhancement sequences when gastrointestinal tract was in hypotonic, patients drank or were primed with water as contrast. Results Thirty patients were diagnosed as recurrent gastric cancer with MRI, 28 of them were confirmed by clinical results. Three patients were missed and two patients were incorrectly misdiagnosed by MRI. Wall thickness of gastric remnant was (4.5±0.3) mm and that of stomas was (6.3±1.4) mm in control group. Types of lesions were found on MRI: thickening of remnant stomach stomas was more than 8 mn(n=30), thickening of neighbor rem-nant stomach stomas was more than 5mm (n=19), mass of stomas (n=11), metastasis of neighbor viscus (n=5), and metastasis of lymph nodes (n=9). On enhancement scan, 9 patients showed inhomogeneous enhancement in arterial phase and 30 patients showed gradual delayed enhancement in venous phase and equilibrium phase. Conclusion MRI is an effective imaging method in illustrating wall thickness of gastric remnant and stomas, invasion depth by carcinoma, relationship with neighbor tissue structures and metastasis of lymph nodes and abdominal viscus. It plays an important role in directing clinical therapy.     

钼靶结合MRI对乳腺导管原位癌诊断价值的探讨

目的:分析乳腺导管原位癌的X线及MRI表现,评价钼靶结合MRI对DCIS术前诊断价值。方法:回顾性分析经手术病理证实的乳腺DCIS病例13例,所有病例均于术前行动态增强MRI和钼靶X线检查,同时行免疫组化标记。结果:①将病灶的X线表现分成恶性钙化、中间性钙化和非钙化3组,PR与C-erbB-2在3组中的分布有统计性意义(P<0.05);②13例病灶中11例MR表现为非肿块样强化,以BI-RADS分级中的4、5级为MR和X线检查的阳性指标,其正确诊断率差异无统计学意义(P>0.05)。结论:DCIS的钼靶X线表现可以作为乳腺DCIS的预后因子,乳腺MRI对导管原位癌及导管原位癌伴微浸润有特征性表现,钼靶X线和MR检查相结合能提高早期导管原位癌的检出率及正确诊断率。     

The role of magnetic resonance imaging on spinal trauma.

Spinal MR has an increasingly important role in the assessment of spinal trauma. The ability to visualise clearly the spinal cord, nerve roots, ligaments, intervertebral discs and adjacent vascular structures allow a more accurate assessment of the extent of injury, and necessity for further management and provide a prognosis for recovery.     

Contrast-enhanced magnetic resonance imaging of the breast

Contrast-enhanced magnetic resonance (MR) imaging is increasingly used as a complementary diagnostic modality in breast imaging. The sensitivity of MR imaging of the breast for malignancy has consistently been reported to be excellent. The specificity has been rather variable. Study methods and imaging techniques are not standardized and there is still a great deal of uncertainty about MR imaging's place in clinical practice. Nevertheless, radiologists should be familiar with the current technique and the varying MR appearance of breast tumors to improve the accuracy of this method. This paper reviews the techniques for breast MR imaging, the pathopysiologic basis of contrast enhancement in breast tumors, and the current knowledge about detection and differentiation of breast tumors. In addition, future directions for breast MR imaging are discussed.     

Magnetic resonance imaging in recurrent carcinoma of the cervix

Twenty patients with suspected recurrent cervical carcinoma were evaluated with computed tomography (CT) and high-field magnetic resonance imaging (MRI). Histological verification of the imaging findings were available in all cases. Computed tomography and MRI were equally effective in making the diagnosis of disease recurrence. The extent of vaginal recurrence and involvement of pelvic floor muscles was better shown on MRI than on CT.     

Evaluating the role of transrectal ultrasonography and magnetic resonance imaging in prostate carcinoma

A review of the recent literature on the performance of transrectal ultrasonography and MR imaging in the evaluation of prostate carcinoma demonstrates the typical evolutionary cycle inherent in any technology assessment: increasingly improved methodology has resulted in the tempering of initial enthusiastic reports by more sober observations and realistic expectations. This inevitable and predictable evolution should not be interpreted as a criticism of earlier work; designing and implementing a rigorous study of new and rapidly changing technology is a challenging endeavor. Nevertheless, the most current work has greatly helped to provide a more balanced and convincing perspective that is more useful to the practicing radiologist.     

Atlas of breast magnetic resonance imaging

Magnetic resonance imaging (MRI) of the breast has become important not only for assessing the extent of breast cancer for breast-conserving surgery but also for the evaluation and diagnosis of other benign and malignant pathologies. We radiologists therefore need to know the appropriate indications for performing breast MRI and understand the MRI features of breast disease. We herein review and discuss the application of current pulse sequences and the imaging strategies for MRI of breast pathologies. We will illustrate the MRI features of various breast pathologies including malignant tumors such as invasive and noninvasive ductal carcinoma, special types of invasive carcinoma (mucinous, apocrine, lobular carcinoma, spindle cell carcinoma, and so on), inflammatory carcinoma, semimalignant tumor (phyllodes tumor), benign tumors (fibroadenoma, intraductal and intracystic papilloma), inflammatory conditions, and postsurgical changes. We will also demonstrate three-dimensional fusion images of MR ductography and breast MRI of patients with nipple discharge.     

The role of magnetic resonance imaging in cystic fibrosis

Magnetic resonance imaging (MRI) of the chest was performed on eight patients with known cystic fibrosis. Comparison was made with the findings on plain chest radiographs. MRI shows a greater extent of disease than that predicted by the chest films alone and clearly demonstrates peribronchial thickening and mucoid impacted bronchi. It also distinguishes between hilar lymphadenopathy and enlarged proximal pulmonary vessels as the cause of prominent hilar shadows without the need for contrast injection.     

Detection of local recurrent disease in musculoskeletal tumors: magnetic resonance imaging versus computed tomography

A 2 1/2-year prospective study of surgically treated malignant mesenchymal neoplasms showed magnetic resonance imaging (MRI) to be superior to computed tomography (CT) in sensitivity for local recurrent disease measuring less than 15 cm³. Larger masses were detected with similar sensitivity; specificity and predictive values did not differ. The presence of areas of high signal intensity on T2-weighted images proved to be a reliable criterion except in fibrous neoplasms. However, differentiation between non-hemorrhagic fluid collections, cross-sectioned veins or bowel contents and small tumor nodules cannot be made simply by signal intensity, but has to be based upon the evaluation of gross morphologic criteria.     

The role of magnetic resonance imaging (MRI) in assessment of ACL graft failure

Objective

The aim of this work is to assess the role of MRI in the diagnosis of ACL graft failure and detection of complications that may follow ACL reconstruction.

The use of magnetic resonance imaging in breast cancer screening

Screening mammography is a powerful tool for reducing breast cancer mortality. Mammography can often detect clinically occult, early-stage breast cancer that is amenable to successful treatment. However, mammography is not a perfect test and has lower sensitivity in young women and in those with dense breasts. Magnetic resonance imaging (MRI) has been shown to depict breast cancers that are occult to other forms of detection, including mammography. This has generated interest in the use of MRI for breast cancer screening. Although preliminary studies in highly selected populations show promise for the potential efficacy of breast cancer screening with MRI, there are many questions that should be addressed before this technique is offered to the general population.     

MR在乳腺肿瘤中的应用

随着MR成像技术的不断发展，MRI诊断乳腺疾病的敏感性有了很大的提高。近年来MRS及MR引导的乳腺定向活检技术的临床应用，进一步提高了腿诊断乳腺疾病的特异性。就近年文献中有关乳腺肿瘤的腿应用予以综述。     

Inflammatory breast carcinoma in magnetic resonance imaging: a comparison with locally advanced breast cancer

RATIONALE AND OBJECTIVES: Although inflammatory breast carcinoma (IBC) accounts for 1%-4% of all breast cancer cases, the appearance of this highly malignant tumor in magnetic resonance imaging (MRI) is still not well characterized. The aim of this study was to identify typical imaging features of IBC in comparison with noninflammatory locally advanced breast carcinoma (LABC). MATERIALS AND METHODS: MRIs of 48 patients with IBC were compared with an equivalent cohort of 52 subjects with LABC. Age and histopathologic subtype were equivalent between the two groups. To delineate characteristic features, a multitude of dynamic and morphologic parameters were evaluated using T1- and T2-weighted sequences. RESULTS: No significant differences of prevalences could be found for the following criteria: dynamic tumor signal characteristics, prominent vessels, perifocal edema, axillary lymph node involvement, morphology of focal masses, and morphologic pattern of non-mass like enhancement. Otherwise, the quantity of focal masses and the spatial distribution of the tumoral infiltration significantly differed between the two cancer groups. The following parameters occurred more frequently in the IBC cases: edema (cutaneous/subcutaneous 81.3%, perimamillar 70.8%, diffuse 89.6%, prepectoral 72.9%, intramuscular pectoral 41.7%), thickening (75.0%) and pathologic enhancement (60.4%) of Cooper's ligaments, skin thickening (83.3%), punched-out sign (initially strong, focal increase of some dermal or subcutaneous parts followed by slow-continuous enhancement of the surrounding skin; 56.3%). CONCLUSIONS: Inflammatory breast carcinoma seems to represent a specific biological entity resulting in typical MRI characteristics. Some of the parameters are supposed to visualize the characteristic extensive lymphovascular infiltration and therefore may improve the diagnosis of IBC.