直肠系膜及周围筋膜结构的薄层MRI研究  

Thin-Section MRI Study of Mesorectum and Perirectial Fasciae

作　　者：周丹[1] 刘筠[2] 杨秀娟[3] 郝彩仙[2] 许亮[2] 刘振兴[2] 

机构地区：[1]天津医科大学研究生院,300070 [2]天津市人民医院影像学部,300121 [3]重庆三峡中心医院

出　　处：《临床放射学杂志》2015年第2期224-227,共4页Journal of Clinical Radiology

摘　　要：目的探讨直肠系膜及周围筋膜结构的薄层MRI特点,为直肠癌全直肠系膜切除术(TME)提供客观的影像学依据。方法选取30例健康志愿者行常规T1WI、T2WI、T2W SPAIR及薄层T2WI扫描,比较各序列对系膜及筋膜的显示效果,并分析系膜及筋膜结构的MRI表现。结果薄层T2WI(M=5.0)对系膜及筋膜的评分明显高于T1WI(M=3.0)、T2WI(M=3.0)、T2W SPAIR(M=1.0),差异具有统计学意义(P<0.05)。在薄层T2WI上,30例直肠系膜的显示率为100%,直肠固有筋膜分为前方(与Denonvilliers筋膜难以区分)、后方(与骶前筋膜难以区分)、左方、右方筋膜,其显示率分别为96.7%、100%、96.7%、93.3%。结论薄层T2WI优于常规MRI序列,可较好地显示直肠系膜及筋膜的形态特征,能够为直肠癌TME提供客观的影像学依据。Objective To investigate the MRI characteristics of mesorectum and perirectal fasciae, and to provide more objective imaging evidence for the performance of total mesorectal excision of rectal cancer. Methods A total of 30 healthy volunteers were selected. Conventional T^WI, TaWI, T2W SPAIR and thin-section T2WI scans were performed in all examinees, The displaying effects of mesorectum and perirectial fasciae by these MRI sequences were determined and the results were compared among these MRI sequences. Results The displaying scores of mesorectum and perirectial fas- ciae on thin-section T2 WI （ M = 5.0） were significantly higher than those on T 2 WI （ M = 3.0） , T2 WI （ M = 3.0） and T2 W SPAIR （ M = 1.0） ; the differences between them were statistically significant （ P 〈 0.05 ）. On thin-section T2 WI, the dis- playing rate of mesorectum was 100% （30/30）, and the displaying rates of the anterior, posterior, left and right mesorec- tal fascia were 96.7% , 100% , 96.7% and 93.3% respectively. The anterior mesorectal fascia was difficult to distinguish from Denonvilliers fascia and the posterior mesorectal fascia was difficult to distinguish from prescaral fascia. Conclusion Thin-section T2 W1 is superior to conventional MRI in displaying the morphological characteristics of mesorectum and peri- rectal fasciae, which can provide more objective imaging evidence for the performance of total mesorectal excision of rectal cancer.

关 键 词：直肠 系膜 筋膜 薄层 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤]