Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma

악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가

  • Lee, Eunsol (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Chae, Eun Jin (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kang, Sunji (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yeom, Yoo Kyeong (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Hyun Joo (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Jong Chun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Shin, So Youn (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Yoon Young (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Joon Ho (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Do, Kyung-Hyun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • 이은솔 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 채은진 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 강선지 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 염유경 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 이현주 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 박종천 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 신소연 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 최윤영 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 최준호 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소) ;
  • 도경현 (울산대학교 의과대학, 서울아산병원 영상의학과 영상의학연구소)
  • Received : 2013.08.20
  • Accepted : 2013.09.17
  • Published : 2013.09.30
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Abstract

Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.

목적 : 악성흉막중피종 (이하 MPM)의 임상적 병기판정에 있어 자기공명영상 (이하 MR)의 진단적 유용성을 컴퓨터단층촬영(이하 CT)과 비교하였다. 대상 및 방법 : 1997년부터 2012년까지 MPM으로 확인된 환자 중 진단 시 CT와 MR을 얻은 환자 20명 (남:여=14:6; 평균연령= 53.5세)을 대상으로 하였다. CT 혹은 MR 단독을 이용하여 두 명의 영상의학과 의사가 의견 일치 하에 병기판정을 시행하였다. 수술적 병기판정을 받은 환자의 경우 이와 비교하여 CT 단독 및 CT와 MR을 함께 시행하였을 때의 진단적 정확도를 평가하였다. 또 CT 단독과 CT와 MR을 함께 시행하였을 때의 임상병기의 일치도를 비교하였다. 결과 : CT를 이용한 T stage의 정확도는 23.1% (3/13)였고 MR과 함께 시행한 경우 38.5% (5/13)였다. CT 및 MR을 함께 시행한 경우 수술 후 수술적 병기에서 5명의 환자는 상위 진단을, 3명의 환자는 하위 진단을 보였다. CT 단독 및 CT와 MR을 함께 시행한 병기를 서로 비교하였을 때 85.0% (17/20)의 일치도를 보였고 불일치한 예(3명)에서는 함께 시행한 경우 CT 단독보다 상위 진단을 하였다. 결론 : MPM의 병기판정에 있어서 MR을 함께 시행한 경우 CT 단독에 비해 보다 높은 정확도의 병기판정을 제공하여 수술대상이 되는 환자에서 수술 전 검사로서 중요한 역할을 수행할 것으로 기대된다.

Keywords

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