双重超声造影与动态增强MRI在直肠癌术前诊断的应用价值  

The value of double contrast-enhanced ultrasonography and DCE-magnetic resonance imaging in preoperative evaluation of pectal cancer

作　　者：卢漫[1] 宋彬[2] 岳林先[1] 宋军[1] 吴平[1] 魏秋鑫[1] 马懿[1] 雷利[1] 蔡志清[1] 

机构地区：[1]四川省医学科学院.四川省人民医院超声科,四川成都610072 [2]四川大学华西医院放射科,四川成都610041

出　　处：《实用医院临床杂志》2012年第4期52-57,共6页Practical Journal of Clinical Medicine

基　　金：四川省科技厅科研基金资助项目(编号:2009SZ0173)

摘　　要：目的探讨双重超声造影及动态增强MRI对直肠癌术前诊断的临床价值。方法对35例直肠肿瘤患者行双重超声造影(double contrast-enhanced ultrasonography,DCEUS)及动态增强MRI(dynamic contrast-enhanced magnetic resonanceimaging,DCE-MRI),比较DCEUS和DCE-MRI对直肠癌的检出率、定位准确性、对直肠癌术前超声T分期、N分期符合率以及肿瘤的增强特征,并与手术病理比较。结果 35例患者,术前DCEUS和DCE-MRI的检出率和定位准确率均100%,DCEUS和DCE-MRI的T分期符合率分别为85.7%和82.9%,Kappa值分别为0.782(P<0.001)和0.739(P<0.001)。术前DCEUS和DCE-MRI的N分期符合率分别为77.1%和80.0%,kappa值分别为0.624(P<0.001)和0.668(P<0.001)。结论 DCEUS和DCE-MRI均是术前诊断和评价直肠癌的有用的方法。Objective To study the clinical value of double contrast-enhanced ultrasonography（DEUS） and dynamic contrastenhanced magnetic resonance imaging（DCE-MRI） in Preoperative evaluation of Rectal Cancer. Methods Thirty-five patients with rectal tumour underwent DCUS and DCE-MRI. The results were correlated with the histopathological findings based on the lesion site, morphology, size, contrast enhancement of lesions, the deep layers of the rectal wall and TN stating. Results Of the 35 patientes, all tumor loctions were correctly diagnosed with DEUS and DCE-MRI. T staging with DEUS correlated with the histopathological findings in 85. 7% of patients （ kappa = 0. 782, P 〈 0. 001 ）, by MRI in 82.9% patients （kappa = 0. 739, P 〈 0. 001 ）. Local lymphatic node involvement was correctly diagnosed with DEUS and MRI in 77.1% of patients （ kappa=0. 624 ,P 〈 0. 001 ） and 80% of patients（ kappa=0. 668 ,P 〈 0. 001 ）, respectively. Conclusion It was useful to correct preoperative identification and precise evaluation of rectal tumour, by DCEUS and DCE-MRI, to decide optimal treatment strate.

关 键 词：超声造影 磁共振成像 直肠癌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]