A Study On The Application Of Vascular Invasion In Primary Mediastinal Tumors On CT And MRI

PurposeTo explore the Magnetic Resonance Imaging(MRI) and Contrast Enhancement-CT (CE-CT) on evaluation of vascular invasion in primary mediastinal tumors.Material and MethodsThirty patients with primary mediastinal tumors and which were going to have surgical therapy, underwent chest MRI check (including T1WI, T2WI, T2WI/fs, CE-MRI) and CE-CT. The diagnostic criteria of the tumor which has invaded the vessel are: (1)The fat between the tumor and the vessel disappeared. (2)The tumor surrounded more than half of the vessel wall. (3)The vessel become narrowing when surrounded by tumor. (4)The density or signal of the vessel wall become abnormal. (5)Embolus appearance.Coincidencing with one of the above condition, it is consider that the vessel had been invaded.1,By means of the criteria above, the data of the CT and MR Imaging were analyzed. The relation between the tumor and the vessel was confirmed by operation and pathology. Finaly, the imaging and pathology result were compared.2,The Pathology of each MRI manifestation which indicated the vessel had invaded was comfirmed.Statistical AnalysisThe statistical analysis were performed with the statistcal software packgae SPSS for Widow, version 13.0, including Cochrans'Q test, andκtest.Results1. The sensitivity, specificity, positive predictive value, negative presitive and accuracy for the five imaging (including T1WI, T2WI, T2WI/fs, CE-MRI and CE-CT), detecting whether the vessel had been invded or not, had been tested by Cochrans'Q test. The Q were 121.945, 10.667, 14.764, 20.586, 106.362 respectively,P<0.05. Theκwere 0.713,0.776,0.296,0.232,0.619 respectively, when compared with each imaging and pathology.2.Κappa value for MRI each criteria on vascular ivasion were 0.737,0.386,0.410,0.232,0.238 respectively.ConclusionT2WI is the optimum imaging for evaluation of whether the vessel had been invded or not , and T1WI, CE-CT, T2WI/fs, CE-MRI. The accuracy is biggest, for the disappearance of the fat between the tumor and the invded vessel. The specificity of MRI is biggest, for detecting the abnormal signal on invded vessel wall and blood vessel embolus. The preoperative MRI examination is necessary for detecting the vessel had been invded or not.