高分辨率MRI在头面部中高危区域皮肤基底细胞癌诊断中的应用  

Application of high-resolution MRI in diagnosis of cutaneous basal cell carcinoma occurring in medium-or high-risk areas of head and face

作　　者：余秋雨 滕跃[1] 唐梦晓 李平[1] 李勇刚[1] 周乃慧[3] 张晓萍 YU Qiuyu;TENG Yue;TANG Mengxiao;LI Ping;LI Yonggang;ZHOU Naihui;ZHANG Xiaoping(Department of Radiology,the First Afiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China;Department of Radiology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,China;Department of Dermatology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006 [2]浙江大学医学院附属邵逸夫医院放射科,浙江杭州310016 [3]苏州大学附属第一医院皮肤科,江苏苏州215006

出　　处：《实用放射学杂志》2023年第1期21-25,共5页Journal of Practical Radiology

基　　金：中国科学院国家自然科学基金资助项目(81671743);苏州市卫生和计划生育委员会临床重点疾病诊疗专项项目(LCZX201801);苏州市卫生人才项目(GSWS20202009);江苏省六大产业高级人才计划项目(WSW-057)。

摘　　要：目的探讨高分辨率磁共振成像(HR-MRI)在发生于头面部中高危区域的皮肤基底细胞癌(BCC)的术前诊断中的价值.方法收集13例头面部中高危区域BCC患者的临床及影像资料,对病变的大小、信号特征、边缘、强化、动态增强时间-信号强度曲线(TIC)类型、深度及累及层次进行观察和评估.结果病灶平均最大径为(19.4±11.0)mm.T1WI均呈等或低信号,T2WI信号表现多样.9例病灶边界模糊.10例病灶均匀强化,所有病灶均呈等、低强化,TIC表现为Ⅰ型或Ⅱ型.病灶平均深度为(7.2±3.2)mm,9例累及皮下脂肪以下深层结构.结论BCC在HR-MRI表现多样,低强化、低灌注为相对特异表现.HR-MRI可以术前无创评估病变的范围及对周围结构的浸润,对指导治疗和手术决策具有较大价值.Objective To investigate the value of high-resolution magnetic resonance imaging(HR-MRI)in the preoperative diagnosis of cutaneous basal cell carcinoma(BCC)occurring in medium-or high-risk areas of head and face.Methods The clinical and imaging data of thirteen patients with BCC occurring in medium-or high-risk areas of head and face were collected.The size,signal feature,margin,enhancement,type of dynamic contrast enhanced time-signal intensity curve(TIC),depth and invasion layer of these cases were observed and assessed.Results The mean maximum diameter of all enrolled lesions was(19.4±11.0)mm.All lesions showed iso-or hypointense at T,WI,while were heterogeneous at T,WI.Nine cases presented poorly-defined margins.Ten cases were homogeneously enhanced.All cases showed an iso-or hypoenhancement,TIC presented as type Ⅰ or type Ⅱ.The mean depth of all lesions was(7.2±3.2)mm,and 9 cases involved deeper layers below the subcutaneous fat.Conclusion BCC have diverse imaging manifestations on HR-MRI,with hypoenhancement and hypoperfusion being relatively specific.HR-MRI allows non-invasive evaluation on the extent of lesions,plus infiltrated status of the surrounding structures preoperatively,which can be of great value in guiding treatmentand surgical decisions.

关 键 词：高分辨率磁共振成像 基底细胞癌 皮肤肿瘤 动态对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.5[医药卫生—诊断学]