Atila EROĞLU, Alpaslan YAVUZ, Yener AYDIN, Recep SADE, Abdussamed BATUR, Mesut ÖZGÖKÇE, Fatih ALPER, Hayri OĞUL

Özofagus kanserinde invazyonun değerlendirilmesinde konvansiyonel manyetik rezonans görüntüleme, sine-manyetik rezonans görüntüleme ve ameliyat bulgularının karşılaştırılması

Amaç: Bu çalışmada özofagus kanserinde konvansiyonel manyetik rezonans görüntüleme ve sine- manyetik rezonans görüntüleme ile invazyon varlığı açısından ortaya çıkan bulgular ameliyat sonuçları ile karşılaştırıldı.Çalışma planı: Bu prospektif çalışmaya Ocak 2012 - Şubat 2016 tarihleri arasında özofagusta tespit edilen kitlelerde invazyon varlığı ya da yokluğu açısından şüpheli toplam 37 olgu (21 erkek, 16 kadın; ort. yaş 63.3 yıl; dağılım 28-81 yıl) alındı. Tüm olgularda öncelikle konvansiyonel manyetik rezonans görüntüleme (T1- ağırlıklı, T2-ağırlıklı, short tau inversion recovery) ile lezyon özellikleri ve invazyon alanları araştırıldı. İnvazyonlu olgular, lezyonun dinamik özellikleri ve komşu dokular üç planda sine -manyetik rezonans görüntüleme alınarak tekrar değerlendirildi. Kitlenin komşu dokular ile olan bağıl hareketi, yağlı düzlemler ve invazyon durumu, boyut ve yapıya göre değerlendirildi.Bulgular: Olguların tümünde konvansiyonel manyetik rezonans görüntüleme ile invazyon varlığı saptandı. Otuz yedi olgudan 28’inde sine-manyetik rezonans görüntüleme ile invazyon saptanmaz iken, dokuz olguda tespit edildi. İnvazyon tespit edilmeyen 28 olgunun 20’si ameliyat edildi ve sonuçlar sine -manyetik rezonans görüntüleme bulguları ile uyumlu idi. Kalan sekiz olgu ise, ciddi komorbiditeler ve ameliyatı reddetme nedeni ile ameliyat edilemedi.Sonuç: Kalp ve ana vasküler yapılar gibi hareketli dokulara yakın komşulukta olan özofagus kanserinde invazyonun doğru tespit edilmesinde sine-manyetik rezonans görüntüleme katkı sağlayabilir. Çalışma sonuçlarımıza göre, sine-manyetik rezonans görüntüleme, konvansiyonel manyetik rezonans görüntülemeden üstün görünmektedir.

Comparison of conventional magnetic resonance imaging, cine-magnetic resonance imaging, and operation findings in invasion assessment of esophageal cancer

Background: This study aims to compare the conventional magnetic resonance imaging and cine-magnetic resonance imaging findings with the operation results in terms of invasion existence in esophageal cancer.Methods: This prospective study included a total of 37 suspected cases (21 males, 16 females; mean age 63.3 years; range 28 to 81 years) with respect to whether or not invasion in esophageal masses between January 2012 and February 2016. Initially, conventional magnetic resonance imaging (T1-weighted, T2-weighted, short tau inversion recovery), lesion characteristics and invasion areas were evaluated in all cases. The cases with invasion were re-evaluated according to dynamic moving features of the lesion and adjacent tissue by cine-magnetic resonance imaging in three planes. The relative motion of the mass with adjacent tissues, fatty planes, and invasion status were evaluated according to size and structure.Results: The presence of invasion was detected by conventional magnetic resonance imaging in all of the cases. Invasion was not detected in 28 of 37 cases, while it was observed in nine cases by cine -magnetic resonance imaging. Twenty of 28 non-invasion cases were operated and results were compatible with the cine-magnetic resonance imaging results. The remaining eight cases were not operated due to severe comorbidities and the refusal of operation.Conclusion: Cine-magnetic resonance imaging may contribute to detect invasion accurately in esophagus cancer which is adjacent to moving tissues such as heart and main vascular structures. Based on our study results, cine -magnetic resonance imaging appears to be superior to conventional magnetic resonance imaging.

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