Résumé
Objective To discuss the magnetic resonance imaging(MRI) characteristics of spine and spinal cord deformity in children.Methods Thirty-three children with spine and spinal cord deformity underwent MRI examination from Jan.2010 to Dec.2012.The technique was to obtain spin echo(SE) sagittal T1WI and fast spin echo(FSE) T2WI as well as axial FSE T2WI.Coronal FSE T2WI was added when necessary.Results There were 17 cases with spine deformity,accounting for 51.5％ of all patients,12 cases with both spine and spinal cord deformity,accounting for 36.4％ of all patients,4 cases with sacral canal cyst,accounting for 12.1％ of all patients.There were 4 cases of scoliosis,22 cases of scoliosis accompanying vertebral or spinal cord deformity,2 cases of atlas assimilation and basilar impression,1 case of bifid spine of the sacrum.Conclusions There are a great variety of paediatric spine and spinal cord deformities,and they always coexist.MRI can supply accurate diagnosis and useful information for clinic.
Résumé
<p><b>BACKGROUND</b>Early detection and accurate staging are crucial for planning treatment and improving survival rate of hilar cholangiocarcinomas. This study investigated the diagnostic value of a three dimensional, spoiled gradient echo, T1-weighted magnetic resonance (MR) imaging sequence (3D volumetric interpolated breath-hold examination, 3D-VIBE) in the preoperative evaluation of hilar cholangiocarcinoma.</p><p><b>METHODS</b>Thirty-one patients with surgically and histologically confirmed hilar cholangiocarcinomas underwent preoperative MR imaging examination. Unenhanced two-dimensional T1- and T2-weighted images, 2D MR cholangiopancreatographs (MRCP), gadolinium enhanced 3D-VIBE images in the early arterial, late arterial and portal venous phases followed by 2D T1-weighted images in the equilibrium phase were acquired. Images from 3D-VIBE, 2D T1-weighted enhanced sequences and 2D MRCP were interpreted by two abdominal radiologists through consensus reading in blind manner, focussing on the assessment of the morphological type, the longitudinal extent of tumor infiltration in the bile ducts and the involvement of neighbouring blood vessels. The accuracy of 3D-VIBE and 2D T1-weighted enhanced sequences in assessing the tumor resectability was compared.</p><p><b>RESULTS</b>All the 31 tumors were directly displayed and accurately classified on 3D-VIBE images whereas 8 periductal infiltrating tumors (8/31, 25.8%) were not depicted on 2D T1-weighted enhanced images. Using the Bismuth Corlette classification, 3D-VIBE was closer to MRCP in delineating the intraductal extent of tumor infiltration than 2D T1-weighted enhanced (28/31, 90.3%; 10/31, 32.3%; chi2 = 22.0, P < 0.05). Involvement of the hepatic artery, the portal venous trunk and their branches was shown more frequently on 3D VIBE than 2D T1-weighted enhanced images. The positive predictive value and accuracy of 3D-VIBE (84.2%; 90.3%) for assessing tumor resectability were higher than those of 2D T1-weighted enhanced images (64.0%; 71.0%, all P < 0.05).</p><p><b>CONCLUSION</b>Gadolinium enhanced 3D-VIBE is better than 2D T1-weighted enhanced sequence in the preoperative assessment of the morphologicalal type, the intraductal infiltrating extent and the tumor resectability of hilar cholangiocarcinomas.</p>