RESUMO
Magnetic resonance imaging (MRI) is a safe modality for examining the bone marrow and it is quite effective in revealing marrow involvement in hematological malignancies. MRI has been compared with needle marrow biopsy in 22 patients with myelodysplastic disorders. A fairly good concordance has been demonstrated in 79% of cases. However, in 5 patients MRI revealed that bone marrow hyperplasia was not generalized. Therefore in elderly patients with MDS, MRI of the spine allows the quantification of bone marrow hyperplasia with a greater accuracy than bone marrow biopsy and this may be useful for monitoring the effect of cytostatic treatment.
Assuntos
Medula Óssea/patologia , Síndromes Mielodisplásicas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Refratária/etiologia , Biópsia por Agulha , Feminino , Humanos , Hiperplasia/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/complicaçõesRESUMO
Forty-five patients with mediastinal spread of malignant, Hodgkin's and non-Hodgkin's lymphomas were examined with MR Imaging at 0.5 T. Ninety-two examinations were performed at diagnosis and/or during and after treatment to investigate MR capabilities in distinguishing fibrous tissue from active disease in the masses residuing after therapy--which cannot be done by means of CT. MR results indicated T2-weighted sequences to be the most useful. MR results were compared with the data collected from follow-up, clinics, and biology. MR Imaging had high accuracy (92.1%). The number of false negatives was very low, thanks to the low intensity of fibrous tissue, while a relatively high number of false positives was observed, probably due to the difficulties in discriminating inflammatory from neoplastic tissue.
Assuntos
Doença de Hodgkin/radioterapia , Linfoma não Hodgkin/radioterapia , Imageamento por Ressonância Magnética , Neoplasias do Mediastino/radioterapia , Recidiva Local de Neoplasia/diagnóstico , Seguimentos , Doença de Hodgkin/diagnóstico , Humanos , Linfoma não Hodgkin/diagnóstico , Neoplasias do Mediastino/diagnóstico , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
Conventional chest X-rays and CT scans, performed at the time of the initial staging in 67 patients affected by Hodgkin's disease, were reviewed and compared. CT scans provided evidence of disease not shown by concomitant conventional chest X-rays in 10 patients (15%). The impact on patient management of the additional CT data was evident in 8 cases (11.9%), either changing the whole treatment plan (4 patients) or enlarging radiation ports (4 patients). Traditional prognostic features did not influence the outcome, and only hilar adenopathy adversely affected event-free survival, without however reaching statistical relevance (p greater than 0.05). Our data suggest that thoracic CT scan is helpful in drawing up the treatment plan, while its role in identifying new prognostic factors is still uncertain.
