3D-SPACE序列在直肠癌术前T分期中的诊断价值  

Diagnostic value of MRI with 3D SPACE sequence in T staging of rectal cancer

作　　者：孙轶群[1] 童彤[1] 顾雅佳[1] 信超[1] 彭卫军[1] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《肿瘤影像学》2017年第1期25-29,共5页Oncoradiology

基　　金：国家自然科学基金(No:81501437)

摘　　要：目的:探讨三维可变反转角快速自旋回波(3D sampling perfection with application optimized contrasts using different flip angle evolution,3D-SPACE)序列在直肠癌术前T分期中的临床应用价值。方法:回顾性分析复旦大学附属肿瘤医院2015年12月—2016年11月经肠镜活检确诊为直肠癌的患者,其术前未接受放化疗,但行直肠MRI检查。共收集178例,其中107例肿瘤轴位T2WI使用薄层小视野(field of view,FOV)T2WI序列(以下简称高分辨率T2WI序列),71例使用3D SPACE的T2WI序列(以下简称3D SPACE序列),并于2周内进行手术。将MRI所得T分期结果与病理结果进行对照分析,比较两种MRI技术评估直肠癌T分期的灵敏度、特异度、准确率。结果:高分辨率T2WI序列诊断T分期的总准确率为75.7%,3D SPACE序列诊断总准确率为83.0%。对早期T1、T2期的诊断准确率(T1:98.6%vs.88.8%;T2:87.3%vs.75.7%),3D SPACE序列均高于高分辨率T2WI序列;对T3期的诊断准确率,两者相当(85.9%vs.86.0%);而对T4期的诊断,3D SPACE序列优势不明显(95.8%vs.99.1%)。结论:3D SPACE序列可获得高信号比、高分辨率图像,提高直肠癌T分期的准确率,尤其对早期直肠癌的诊断有优势。Objective： To analyze the diagnostic value of MRI with 3D sampling perfection with application optimized contrasts using different flip angle evolution （3D SPACE） sequence in T staging of rectal Cancer. Methods： A total of 178 rectal cancer patients who received surgical resection without neoadjuvant therapy in Fudan University Shanghai Cancer Center between December 2015 and November 2016 were selected. Among them, 107 patients underwent primary MRI with high-resolution T2WI sequence, and 71 patients underwent MRI with 3D SPACE T2WI sequence. The patients received operation in two weeks. The MRI results of T staging were compared with pathological results. The sensitivity, specificity and accuracy were evaluated. Results： The overall accuracy of T staging was 75.7% using high-resolution T2WI, 83.0% using 3D SPACE. The accuracies of T 1 and T2 staging diagnosed by 3D SPACE were higher than those by high-resolution T2WI （TI： 98.6% vs. 88.8%; T2： 87.3% vs. 75.7%）. The accuracy was the same for T3 staging （85.9% vs. 86.0%）. There were no obvious advantages for T4 staging using 3D SPACE. Conclusion： 3DSPACE sequence can obtain high signal intensity ratio and high resolution of images, and has advantages for early T staging of rectal cancer.

关 键 词：直肠癌 磁共振成像 T分期 高分辨率 三维可变反转角快速自旋回波 

分 类 号：R445.2[医药卫生—影像医学与核医学]