薄层MRI联合MR扩散加权成像对直肠癌术前局部分期的价值  

The Value Of Thin-Section MR Imaging Associated with DWI for Preoperative Local Staging of Rectal Cancer

作　　者：亓俊霞[1] 白人驹[2] 张翔[1] 于长路[1] 

机构地区：[1]天津市第三中心医院放射科,300170 [2]天津医科大学总医院放射科,300052

出　　处：《临床放射学杂志》2011年第12期1783-1787,共5页Journal of Clinical Radiology

摘　　要：目的以病理分期作为金标准,探讨薄层MRI联合MR扩散加权成像(DWI)对直肠癌术前局部分期的价值。资料与方法对首诊直肠癌的40例患者进行前瞻性研究。40例均行常规MRI、薄层MRI和DWI后手术治疗并行病理分期。结果薄层MRI较常规MRI能更好地显示肠壁的各层解剖结构及肿瘤对肠壁及邻近结构的侵犯范围和程度。常规MRI、薄层MRI联合DWI两种检查方法行TN分期的准确性分别为45%和67.5%,差异有统计学意义(P=0.044);T分期的准确性分别为65%和85%,差异有统计学意义(P=0.040);N分期的准确性分别为65%和75%,差异无统计学意义(P=0.332)。结论薄层MRI联合DWI在直肠癌术前局部分期(TN分期)方面优于常规MRI,特别是在T分期方面,薄层MRI联合DWI更具优势,准确性提高到85%;在N分期方面,薄层MRI联合DWI与常规MRI相比无明显差别。Objective To discuss the value of thin section MR imaging associated with DWI for preoperative local staging of rectal cancer.Materials and Methods Forty patients with rectal carcinoma were collected and performed conventional MR imaging,thin section MR scan and DWI examinations.The tumors were excised by operation and all of them were confirmed by pathology.Results According to the gold standard of pathological stage,thin section MR imaging was better on showing the anatomic structures of bowel and the invasion to surrounding structures than conventional MR imaging.The statistical analysis about the accuracy of thin section MR imaging associated with DWI and conventional MR imaging revealed ： a.The TN staging accuracy of two methods were 67.5% and 45%;b.The T staging accuracy of two methods were 85% and 65%;c.The N staging accuracy of two methods were 75% and 65%.There was statistical difference of TN staging accuracy,T staging accuracy between two methods（P=0.044,P=0.040）,and no statistical difference of N staging accuracy between two methods（P=0.332）.Conclusion Thin section MR imaging associated with DWI is better than conventional MR imaging in preoperative local staging of rectal cancer（TN）,especially in T staging and raise the accuracy up to 85%.The two methods has no statistical difference in N staging.

关 键 词：直肠癌 分期 磁共振成像 扩散加权成像 准确度 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]