摘要
目的 探讨MRI常规序列结合高分 辨率磁共振成像(HR-MRI)在直肠癌术前 分期中应用价值。方法 回顾性分析71例 经临床病理证实为直肠癌患者的术前MRI 检查资料,并与术后病理对比。结果 以 术后病理检查结果作为“金标准”,术 前MRI常规序列与HR-MRI诊断直肠癌T分期 总准确性为87.5%;其中T1期的准确性、 敏感性、特异性分别为94.44%、81.82%、 98.33%,T2期准确性、敏感性、特异性 分别81.59%、83.33%、80.85%,T3期准 确性、敏感性、特异性分别为98.51%、 93.10%、92.86%,T4期准确性、敏感 性、特异性均为100%;N分期的准确性 84.51%,敏感性84.0%,特异性84.78%; 直肠系膜筋膜的准确性88.73%,敏感性 81.25%,特异性90.91%。结论 MRI常规序 列及HR-MRI可评估直肠前术前T分期、N分 期及直肠系膜筋膜侵犯情况,可为临床确 定手术方案提供客观资料。
Objective To evaluate the value of MRI routine sequence combined with high resolution magnetic resonance imaging (HR-MRI) in preoperative staging of rectal cancer. Methods The preoperative MRI data of 71 patients with rectal cancer confirmed by clinical pathology were analyzed retrospectively. Results With the results of postoperative pathological examination as golden standard, the total accuracy of preoperative MRI routine sequence and HR-MRI in diagnosis of T staging of rectal cancer was 87.5%. The accuracy, sensitivity and specificity in the diagnosis of T1 stage were 94.44%, 81.82% and 98.33% respectively, of T2 stage were 81.59%, 83.33% and 80.85% respectively, of T3 stage were 98.51%, 93.10% and 92.86% respectively, of T4 stage all were 100%, and of N staging were 84.51%, 84.0% and 84.78% respectively. The accuracy, sensitivity and specificity in the diagnosis of mesorectal fascia were 88.73%, 81.25% and 90.91% respectively. Conclusion MRI routine sequence and HR-MRI can be used to evaluate preoperative T staging, N staging and mesorectal fascia invasion of rectal cancer and can provide objective data for determination of surgical plan
【关键词】直肠癌;术前分期;高分辨磁 共振成像
【中图分类号】R735.3+7
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.11.035
前言
直肠癌是临床常见的消化道恶性肿瘤之一,发病率呈逐年上升趋 势。全直肠系膜切除(TME)基于盆腔局部解剖基础提出,完成切除盆腔 筋膜、淋巴结、血管等组织,可降低疾病复发率。有研究指出,术前 辅助放疗联合TME可进一步降低T3、T4期直肠癌术后复发率[1]。因此, 了解术前分期对临床确定手术方案具有指导意义。MRI具有良好的软 组织分辨率、多方位检查的优势,可清楚显示直肠系膜筋膜及解剖结 构,是临床早期诊断直肠癌的有效手段。高分辨率MRI(HR-MRI)采用小 视野、薄层的T2WI成像,不仅能清楚显示肿瘤与周围组织的关系,还 可显示直肠固有筋膜的解剖结构,在诊断术前分期中具有较高的应用 价值[2]。对此,本文回顾性分析71例经临床病理证实为直肠癌患者的 MRI影响资料,并与术后病理比较,现报道如下。
中国CT和MRI杂志
第15卷, 第 11 期
2017年11月
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