腔内线圈及相控阵线圈MRI在直肠癌T分期中的应用  

Applications of Intracavitary Coil and Phased-array Coil in T Staging of Rectal Carcinoma

作　　者：邱大胜[1] 孔祥泉[2] 冯敢生[2] 陈宪[1] 

机构地区：[1]湖北省肿瘤医院放射科,武汉430079 [2]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2009年第2期257-260,共4页Journal of Clinical Radiology

基　　金：湖北省科技厅科技攻关项目(编号2007AA301B25-4)

摘　　要：目的探讨腔内线圈MRI和相控阵线圈在直肠癌T分期中的应用价值。资料与方法经全直肠系膜切除术(TME)的直肠癌患者36例(男21例,女15例,年龄32～68岁,平均48岁)。术前行相控阵线圈高分辨MRI及术后直肠标本腔内线圈MRI,以手术病理为标准,计算两种线圈对直肠癌T分期的准确率。结果肿瘤在T2WI上呈稍低信号,直肠上段8例,中下段22例,下段6例。MRI软质相控阵线圈T分期判断总准确率约80.6%(29/36)。其中T2期准确率50%(3/6),高估50%;T3期准确率86.4%(19/22),低估4.5%(1/22),高估9.9%(2/22);T4期准确率87.5%(7/8),低估12.5%(1/8)。直肠腔内线圈T分期判断总准确率约77.8%(28/36)。T2期准确率83.3%(5/6),高估16.7%(1/6);T3期准确率95.4%(21/22),低估4.5%(1/22);T4期准确率25%(2/8),低估75%(6/8)。两种线圈结合总的T分期判断的准确率为91.7%(33/36)。T2期准确率83.3%(5/6),T3期准确率为95.4%(21/22),T4期准确率87.5%(7/8)。结论相控阵线圈T2、T3期肿瘤准确率不及腔内线圈,T4期肿瘤准确率高于腔内线圈,二者结合可以提高T2、T4期直肠癌T分期的准确率,但总的T分期准确率提高不明显。Objective To approach the value of intracavitary coil and phased array coil in T staging of rectal carcinoma and elevate accuracy rate in T-staging of rectal carcinoma. Materials and Methods Thirty-six patients with rectal carcinoma were underwent （total mesoreetal excision, TME） operation. Phased-array coil was used in preoperative with high resolution MRI and intracavitary coil was used in rectal specimen, the accuracy rate of T stage with intracavitary coil and phased-array coil were calculated for histological findings as gold standard. Results Rectal tumor was low slightly signal on T2WI. The superior rectal carcinoma were 8 cases, the middle and inferior were 20 cases, the inferior were 6cases. The overall accuracy rate was 80.6% （29/36） by soft phased-array coil, including T2 staging 50% （3/6） , W3 staging 86.4% （19/22） , T4 staging 87.5% （7/8）. The rate of overestimation was 50% （3/6） in T2 staging. The rate of underestimation and overestimation was 4.5% （1/22） and 9.9% （2/22） in T3 staging. The rate of underestimation was 12.5% （1/8） in T4 staging. The overall accuracy rate was 77.8% （28/36） by intracavitary coil, including T2 staging 83.3% （5/6） , T3 staging 95.4% （21/22） , T4 staging 25% （2/8）. The rate of overestimation was 16.7% （1/6） in T2 staging. The rate of underestimation was 4.5 % （ 1/22 ） in T3 staging; the rate of underestimation was 75 % （6/8） in W4 staging. The overall accuracy rate of two coils was 91.7% , including T2 staging 83.3% （5/6）, T3 staging 95.4% （21/22） , T4 staging 87.5% （7/8）. Conclusion The accuracy rate of phased-array coil was inferior to intracavitary coil in T2 and W3. W4 staging of phased-array coil was higher than intracavitary coil. The accuracy rate of T staging was elevated and the overall accuracy rate was not elevated for phased-array coil combined with intracavitary coil.

关 键 词：直肠肿瘤 肿瘤分期 腔内线圈 相控阵线圈 

分 类 号：R735.37[医药卫生—肿瘤]