AVAILABILITY OF 3D IMAGE OF MULTI-SLICE CT IN IMAGING DIAGNOSTIC
OF SOFT PART NEOPLASM +* Hori, T; * Takahashi, A; *Ito, R;
*Matsumoto, R; *Maeda, K;*Saito, T
+*Yokohama City Univeristy, Yokohma, JAPAN
[email protected]
INTRODUCTION: Imaging diagnostic of soft part neoplasm was
various with X-ray
computed tomography, MRI, PET, but in late years assembly of 3
dimensions of pictorial image became easy by an appearance of
Multi-detector-row CT. We investigated it, and we examined
availability of 3D pictorial image by Multi-detector-row CT in
imaging diagnostic of soft part neoplasm. METHODS:
Among the soft part neoplasm that we performed
Multi-detector-row CT, and it was made 3D pictorial image from
March, 2004 to March, 2005, we intended for 36 cases that we
performed biopsy or ablative operation, and pathological diagnosis
obtained. The average age was 48 years old
�17-85 � .The sexuality was male 16 cases, woman 20 cases.
The localization of neoplasm was subcutaneous 13cases, 20 cases
in tunica muscularis, tunica muscularis bottom 3 cases. The
neoplasm was present in thigh 8 cases, finger 6 cases, lower leg 5
cases, upper arm, scapular region, cervix, back for each 3 cases.
The pathological diagnosis was done for biopsy or an excision
specimen in 36 cases. It was hemangioma 8 cases, schwannoma 7
cases, MPNST 4 cases, MFH 3 cases (Figure 1), GCT of tendon sheath,
liposarcoma, lipoma for each 2 cases.
We used SIEMENS SOMATOM Sensation 16. The pictorial image made
2D, pictorial image of 3D. We did the exposure condition with
reconstitution 0.75 to 1mm, collimation 0.75mm, helical pitch 1 to
1.5. We contrasted it in all cases. We held the image display law
by Volume rendering method. Work station used Virtual Place
Advance.
We reconstituted pictorial image by Volume rendering method and
made cystography vas level of more than CT value 120, two pictorial
image of soft tissue level of higher than 40 by CT value. The
cystography blood vessel level made 34 cases, the soft tissue level
in 18 cases. The pictorial image estimate went about next four
items. 1. Extent of visualization of neoplasm in 3D-CT. 2. Of the
neoplasm which we depicted (a)Localization of neoplasm
(b)Cystography effect (c)Kind of neoplasm 3. Visualization by
construction pictorial image 4. Visualization of a nutrient vessel
RESULTS:
It was 27 cases out of 36 cases that soft part neoplasm was
depicted in 3D-CT. It was 19 cases that a global image in
particular was depicted. It was 8 cases that part of neoplasm
depicted. It was 9 cases that was not depicted. We investigated
concern with visualization extent and localization of neoplasm. 12
cases out of present 13 cases were 3D-CT subcutaneously, and the
whole neoplasm was depicted. The tumor that we showed in tunica
muscularis was 20 cases, and 8 cases were partial, and 7 cases were
depicted by collection, and 5 cases were not depicted. On the other
hand, the tumor that a tunica muscularis bottom had was 3 cases,
and all cases were not depicted.
We showed grade of neoplasm cystography effect in CT. We defined
grade as cystography effect to five phases in cystography extent.
About 12 cases that we were present subcutaneously, and collection
was depicted in 3D-CT, we investigated cystography effect in 2D-CT.
It was present from Garade 1 to 5 approximately equally. Low Grade
1 of cystography effect and 2 were present in half extent. It was 7
csaes that we were present in tunica muscularis, and image was
depicted in 3D-CT. All cases were Grade4, 5 and cystography effect
were high in 2D-CT (Figure 2). The neoplasm that total
visualization rate was high was MPNST, MFH, GCT of tendon sheath.
It was 14 cases that the concern with visualization of neoplasm in
manufacture pictorial image and 3D-CT was depicted in pictorial
image of cystography blood vessel level, and the thing depicted in
pictorial image of soft tissue level was 10 cases.
We showed concern with visualization of neoplasm by localization
and construction pictorial image of neoplasm. The subcutaneous
neoplasm was depicted in 8 cases, pictorial image of soft tissue
level in pictorial image of cystography blood vessel level by 8
cases. As for the i.m. neoplasm, 6 cases were depicted in pictorial
image of cystography blood vessel level. It was depicted in
pictorial image of
soft tissue level by 2 cases. The visualization of a neoplasm
nutrient vessel was accepted in 19 cases out of 36 cases. This was
useful at broad excision (Figure 3).
Figure 1: It is femur MFH (a). Collection was contrasted in
cystography CT highly, and it was classified in grade 5 (b). A
tumor was present subcutaneously, and image was depicted in
pictorial image of soft tissue level in 3D-CT(c) (d).
Figure 2: It is hypothenar angioleiomyoma (a), and it is
contrasted in cystography CT remarkably and is equivalent to grade
5(b). The localization was subcutaneous. Image was depicted in
3D-CT distinctly(c) (d).
Figure 3: A case is hemangioendothelioma of thenar. Neoplasm had
a consecutive blood vessel. DISCUSSION:
Character of multi-slice CT is high spatial resolution, high
temporal resolution and multinodular sectional reconstruction. We
gathered up character of 3D-CT of soft part neoplasm and can image
neoplasm three-dimensionally and are effective in operation plan.
Handling of intraoperative tumor vessel becomes easy by depicting
concern with a blood vessel. Efficiency is high even if we compare
it with 2D-CT and MRI for imaging diagnostic of neoplasm,
hemangioma in particular. The soft part neoplasm which it is easy
to be depicted in 3D-CT does localization in a superficial layer, a
high thing of cystography effect
We make 3D pictorial image of multi-slice CT for soft part
neoplasm 36 cases and reviewed it about visualization of various
assumption and neoplasm.Visualization of a high tumor of
cystography effect was good, and concern with periphery vas and a
nutrient vessel was clear. The low neoplasm of cystography effect
was able to depict localization in the case of subcutis, but a deep
neoplasm is difficult and requires a device more in future.
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Paper No: 185252nd Annual Meeting of the Orthopaedic Research
Society
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