IRM corps entier 1, 5 T avec séquence de diffusion dans l'évaluation du cancer à propos de 124 cas / 1. 5 T Whole Body MRI with diffusion sequence in cancer assessment about 124 cases

L'IRM corps entier de diffusion 1,5T est une technique d'imagerie qui fournit des renseignements aussi bien morphologique que fonctionnel avec de nombreuses indications notamment dans les pathologies cancéreuses. Objectif: Faire le bilan d'activité de l'IRM corps entier en insistant sur son apport dans la pathologie cancéreuse. Méthodologie:Etude transversale descriptive avec collecte rétrospective des donnéesincluant les patients ayantréalisé une IRM corps entier pourtumeur maligne sur une période de quatre ans. La saisie et l'analyse des données ont été réalisées grâce aux logiciels Epi Info.Résultats:31,19% des patients avaient un âge compris entre 61 et 70 ans. Le cancer de la prostate était le plus représenté avec 34,68% suivi du cancer du sein 31,45%. L'IRM corps entier était réalisée pour le bilan d'extension dans 39,52% et dans 37,10% pour un bilan d'évolutivité. Les localisations métastatiques étaient observées dans 49% des cas avec une atteinte prépondérantede l'étage abdomino-pelvien 72,13%. Les localisations métastatiques osseuses étaient de 73,77%,hépatiques 26,23% et pulmonaire 14,75%. Les atteintes ganglionnaires de 57,14%. Une progression tumorale a été observée chez 53,33% des patients lors du suivi.Conclusion: L'IRM corps entier permet une fine analyse dans l'évaluation de la pathologie cancéreuse pour l'extension tumorale, la réponse thérapeutique et la recherche de cancer primiti

1.5T whole-body diffusion MRI is imaging that provides both morphological and functional information.It presents several indicationsparticularly in oncology. Objective: Assess the activity of whole-body MRI, emphasizing its contribution to oncologyMethodology:Descriptive retrospective study of patients who had undergone whole-body MRIfor malignancy over a four-year period. Data entry and analysis were performed using Epi Info software.Results:31.19% of patients were between 61 and 70 years old. Prostate cancer was the most represented with 34.68% followed by breast cancer 31.45%.Whole-body MRI was requested for an extension assessment in 39.52% and 37.10% for progress assessment. It revealed metastatic abnormalities in 49%. Abdomino-pelvic region was the most affected area with 72.13%. Metastatic organ involvement was predominantly in the bone 73.77%, followed by the liver 26.23% and the lung14.75%. Lymph node involvement was 57.14%.Tumor progression was observed in 53.33% of patients during follow-up.Conclusion:Whole body MRI allows a fine analysis in the evaluation of the cancerous pathology for the tumor extension, the therapeutic response and the search for primary cancer

Whole-body magnetic resonance imaging in children: state of the art / Ressonância magnética de corpo inteiro em pediatria: estado da arte

Whole-body imaging in children was classically performed with radiography, positron-emission tomography, either combined or not with computed tomography, the latter with the disadvantage of exposure to ionizing radiation. Whole-body magnetic resonance imaging (MRI), in association with the recently developed metabolic and functional techniques such as diffusion-weighted imaging, has brought the advantage of a comprehensive evaluation of pediatric patients without the risks inherent to ionizing radiation usually present in other conventional imaging methods. It is a rapid and sensitive method, particularly in pediatrics, for detecting and monitoring multifocal lesions in the body as a whole. In pediatrics, it is utilized for both oncologic and non-oncologic indications such as screening and diagnosis of tumors in patients with genetic syndromes, evaluation of disease extent and staging, evaluation of therapeutic response and post-therapy follow-up, evaluation of non neoplastic diseases such as multifocal osteomyelitis, vascular malformations and syndromes affecting multiple regions of the body. The present review was aimed at describing the major indications of whole-body MRI in pediatrics added of technical considerations.

A avaliação de corpo inteiro em crianças era classicamente realizada com radiografias simples, cintilografia e tomografia por emissão de pósitrons combinada ou não à tomografia computadorizada, estes com a desvantagem de exposição à radiação ionizante. A ressonância magnética de corpo inteiro (RMCI), associada ao desenvolvimento de técnicas metabólicas e funcionais como difusão, trouxe a vantagem de uma avaliação global do paciente pediátrico sem os riscos da radiação ionizante habitualmente presente nos métodos radiológicos convencionais. A RMCI é um método rápido e sensível, com aplicação especial na área de pediatria na detecção e no monitoramento de lesões multifocais no corpo como um todo. Em pediatria, esta técnica é utilizada tanto em oncologia - no diagnóstico e rastreamento de tumores em pacientes portadores de síndromes genéticas, na avaliação da extensão de doenças e estadiamento oncológico, na avaliação da resposta terapêutica e no seguimento pós-terapêutico - como em lesões não neoplásicas - osteomielite multifocal, malformações vasculares e síndromes que comprometam múltiplas regiões do corpo. Esta revisão tem como objetivo mostrar as principais indicações do exame na população pediátrica e técnica de realização.

Whole-Body MRI in Children: Current Imaging Techniques and Clinical Applications

Whole-body magnetic resonance imaging (MRI) is increasingly used in children to evaluate the extent and distribution of various neoplastic and non-neoplastic diseases. Not using ionizing radiation is a major advantage of pediatric whole-body MRI. Coronal and sagittal short tau inversion recovery imaging is most commonly used as the fundamental whole-body MRI protocol. Diffusion-weighted imaging and Dixon-based imaging, which has been recently incorporated into whole-body MRI, are promising pulse sequences, particularly for pediatric oncology. Other pulse sequences may be added to increase diagnostic capability of whole-body MRI. Of importance, the overall whole-body MRI examination time should be less than 30-60 minutes in children, regardless of the imaging protocol. Established and potentially useful clinical applications of pediatric whole-body MRI are described.

RM de corpo inteiro: avaliação de protocolo em equipamento 3T com 48 canais em menos de 40 minutos. Resultados preliminares / Whole-body MRI: comprehensive evaluation on a 48-channel 3T MRI system in less than 40 minutes. Preliminary results

OBJECTIVE: To evaluate a comprehensive MRI protocol that investigates for cancer, vascular disease, and degenerative/inflammatory disease from the head to the pelvis in less than 40 minutes on a new generation 48-channel 3T system. MATERIALS AND METHODS: All MR studies were performed on a 48-channel 3T MR scanner. A 20-channel head/neck coil, two 18-channel body arrays, and a 32-channel spine array were employed. A total of 4 healthy individuals were studied. The designed protocol included a combination of single-shot T2-weighted sequences, T1-weighted 3D gradient-echo pre- and post-gadolinium. All images were retrospectively evaluated by two radiologists independently for overall image quality. RESULTS: The image quality for cancer was rated as excellent in the liver, pancreas, kidneys, lungs, pelvic organs, and brain, and rated as fair in the colon and breast. For vascular diseases ratings were excellent in the aorta, major branch vessel origins, inferior vena cava, portal and hepatic veins, rated as good in pulmonary arteries, and as poor in the coronary arteries. For degenerative/inflammatory diseases ratings were excellent in the brain, liver and pancreas. The inter-observer agreement was excellent. CONCLUSION: A comprehensive and time efficient screening for important categories of disease processes may be achieved with high quality imaging in a new generation 48-channel 3T system.

OBJETIVO: Avaliar protocolo de RM para investigação de neoplasia, doenças vascular e degenerativa/inflamatória da cabeça à pelve em menos de 40 minutos em equipamento 3T com 48 canais. MATERIAIS E MÉTODOS: Todos os exames foram realizados em equipamento 3T com 48 canais. Foram utilizadas bobinas de cabeça/pescoço (20 canais), duas de corpo interligadas (18 canais) e uma de coluna (32 canais). Quatro voluntários saudáveis foram estudados. Foi utilizado protocolo com sequências single shot pesadas em T2 e gradiente-eco 3D pesadas em T1 pré e pós-gadolínio. Todas as imagens foram avaliadas quanto à qualidade, retrospectivamente, por dois radiologistas de forma independente. RESULTADOS: A qualidade da imagem foi classificada como excelente para o fígado, pâncreas, rins, pulmões, órgãos pélvicos e encéfalo, e como adequada para cólon e mamas. Para as doenças vasculares as imagens foram classificadas como excelentes para aorta e seus ramos principais, veia cava inferior, veias porta e hepáticas, como boas para artérias pulmonares, e como inadequadas para coronárias. As classificações para doenças degenerativas/inflamatórias foram excelente no encéfalo, fígado e pâncreas. A concordância interobservador foi excelente. CONCLUSÃO: Um rastreamento abrangente de importantes categorias de doenças pode ser realizado utilizando imagens de alta qualidade obtidas em uma nova geração de equipamento 3T com 48 canais.