GIÁ TRỊ CỦA CHỤP CỘNG HƯỞNG TỪ TRONG CHẨN ĐOÁN XÂM LẤN TIM - MẠCH MÁU LỚN CỦA U TRUNG THẤT TRƯỚC

Abstract

Objective: Assessing the degree of adhesion/invasion of anterior mediastinal tumors to cardiovascular structures is crucial in surgical planning and treatment prognosis. This study aims to determine the value of CINE sequences in cardiac magnetic resonance imaging (MRI) for diagnosing adhesion or invasion of anterior mediastinal tumors into adjacent cardiovascular structures. Methods: This cross-sectional descriptive study included patients with anterior mediastinal tumors who underwent surgery at the University Medical Center Ho Chi Minh City from November 2018 to June 2023. Preoperative cardiac MRI with CINE sequences was performed. Adhesion/invasion to cardiovascular structures, including the heart, thoracic aorta, pulmonary artery, and superior vena cava, was assessed based on two criteria: loss of sliding motion and loss of the fat plane on CINE images. MRI findings were compared with intraoperative evaluations to determine diagnostic accuracy. Results: Among 106 patients, CINE MRI correctly identified 20 out of 23 cases of cardiovascular adhesion/invasion, with three false negatives and three false positives. The highest sensitivity (100%) was observed for cardiac invasion, while the lowest sensitivity (78.6%) was noted for the superior vena cava. The specificity was highest for the thoracic aorta (95.4%) and lowest for the superior vena cava (77.8%). Overall, CINE MRI demonstrated a high diagnostic accuracy of 93.2%. Conclusion: CINE MRI is a valuable imaging modality for assessing adhesion/invasion of anterior mediastinal tumors into cardiovascular structures. It provides critical information for surgical planning, offering improved accuracy in preoperative evaluation compared to traditional imaging techniques.