[MRT of brain metastases. (I) What is the place of screening with T2-weighted sequences?].
Sensitivity and specificity of plain T2-WI and Gd-DTPA enhanced T1-WI were compared by evaluating MR exams of 30 patients with brain metastases. Large lesions with high signal on T2-WI always enhanced (43/43) when a structure (perifocal edema, tumor tissue, central necrosis) was found. Large lesions nearly always enhanced (53/55) even if no such structure was found. 65% of small unstructured white matter lesions with high signal on T2-WI, which are generally considered vascular, did not enhance. Surprisingly, 35% did enhance. Demonstration of blood brain barrier disturbance in these lesions suggested a metastatic origin. In 3 patients with multiple metastases, Gd-DTPA enhanced T1-WI disclosed more than 140 lesions not seen on T2-WI. All of them were located in or adjacent to grey matter. Our results indicate that enhanced T1-WI should be obtained even if T1-WI are normal or show only small white matter lesions.
Hosten
N
N
Radiologische Klinik mit Poliklinik, Universitätsklinikum Rudolf Virchow/Standort Charlottenburg.
Schörner
W
W
Schubeus
P
P
Felix
R
R
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary*; D001943:Breast Neoplasms / Q000175:diagnosis; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis; D005682:Gadolinium; D019786:Gadolinium DTPA; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid
D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA
MRT bei Hirnmetastasen. (I) Welchen Stellenwert hat das Screening mit T2-betonten Sequenzen?