高分辨T2WI对直肠癌局部侵犯的术前评价  

Preoperative Evaluation of Local Invasion from Rectal Cancer Using High Resolution T_2 Weighted Imaging

作　　者：周仲辉 杨明俐[1,3] 朱进 李肃 刘永光[1,2] 康文炎 夏立刚 龚静山 

机构地区：[1]广东省深圳市人民医院 [2]暨南大学第二临床医学院放射科,518020 [3]暨南大学第二临床医学院胃肠外科,518020

出　　处：《临床放射学杂志》2014年第8期1219-1222,共4页Journal of Clinical Radiology

基　　金：深圳市2012年科技计划项目(医疗卫生类)(编号:201202136)

摘　　要：目的探讨高分辨T2WI在直肠癌局部侵犯术前评价的应用价值。方法 49例临床确诊为直肠癌且未接受放化疗并拟手术切除的患者术前行包括横断位高分辨T2WI和常规T2WI的MRI检查,由两位医师依据横断位高分辨T2WI和常规T2WI对肿瘤局部侵犯进行术前评价,其中37例手术切除患者入选本研究。以手术病理分期为标准,评价高分辨T2WI和常规T2WI对直肠癌局部分期判断的准确性。结果依据高分辨T2WI和常规T2WI读片医师1对直肠癌局部分期术前正确指示率分别为89.2%和62.2%,读片医师2为83.8%和59.5%。两位医师读片结果差异均有统计学意义(P值分别为0.03和0.01)。两位读片医师依据高分辨T2WI和常规T2WI对直肠癌局部侵犯评价一致性检验结果分别为0.77和0.60。结论与常规T2WI比较,高分辨T2WI能提高MRI对直肠癌局部分期术前评价的准确性,应作为直肠癌MRI检查的常规扫描序列。Objective To evaluate high-resolution T2 weighted imaging in preoperatively judging local invasion of rectal cancer. Methods A total of 49 patients with pathologically-proved rectal cancer, who had not received chemotherapy or radiotherapy and were planed to receive surgery, underwent MRI scanning, including high resolution T2 weighted and conventional Tz weighted sequences. T2 weighted and conventional Tz weighted images were independently evaluated by two radiologists for preoperative assessment of local invasion of the primary tumors. Thirty-seven patients receiving surgical resection of the tumor were enrolled in this study. Taking surgical and histopathological staging as standard reference, the staging accuracy of rectal cancer by high resolution T2WI and conventional T2WI was determined by using MeNemar test. Results The diagnostic results of doctor A showed that the preoperative correct prediction for T-stage by high resolution T2WI （89.2%） was significantly higher than that by conventional T2 WI （62.2%）, which were 83.8% and 59.5 % respectively by doctor B. The difference was statistically significant （P = 0.03 and P = 0.01 respectively）. The diagnostic consistency between the two doctors by high resolution T2 WI and conventional T2 WI was 0.77 and 0.60 respectively. Condusion Compared with conventional T2 weighted images, high resolution T2 weighted images can improve the preoperative prediction accuracy for rectal cancer T-staging. It is recommended to routinely use high resolution T2 weighted images for the staging of rectal cancer.

关 键 词：直肠癌 分期 磁共振成像 高分辨 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]