3.0T MR高分辨率成像对直肠癌局部浸润的术前影像学评价  

Preoperative evaluation of local infiltration of rectal cancer using high-resolution 3.0T MR

作　　者：王铮[1] 黄仲奎[2] 廖锦元[2] 黎宁钦[2] 宋瑞[2] 

机构地区：[1]广西医科大学附属肿瘤医院医学影像诊断中心,广西南宁530021 [2]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2017年第8期1196-1200,共5页Journal of Practical Radiology

基　　金：广西自然科学基金项目（2010GXNSFA013189）.

摘　　要：目的 探讨3.0T MR高分辨率成像在直肠癌术前局部浸润的评估价值.方法 回顾性分析经手术病理证实的直肠癌患者168例,术前均行MRI常规盆腔、直肠高分辨成像.评价3.0T MR高分辨成像术前T分期的准确性;探讨T3期直肠癌局部浸润特征性影像学表现.结果 直肠癌累及肠周径程度与病理T分期呈中等正相关（rs=0.530, P=0.003）.MRI直肠癌T分期与病理T分期比较,总体诊断准确度为84.52%,各分期MRI征象与病理T分期有较强的相关性（rs=0.837,P=0.001）.MRI诊断T3期直肠癌中,各单一征象以肿瘤结节样外凸特异性最高（91.1%）,肌层信号中断灵敏度最好（89.7%）.而各叠加征象中则以肠壁索条影＋肌层信号中断特异性最高（89.3%）,灵敏度最好（78.0%）.结论 3.0T MR高分辨成像能较好显示直肠癌局部浸润表现,对术前T分期有一定的临床应用价值.Objective To investigate the value of high-resolution 3.0T MR in the assessment of local infiltration of preoperative rectal cancer.Methods A total of 168 patients pathologically proved rectal cancer underwent both conventional pelvic and rectal high-resolution before operation, and the imaging findings were reviewed retrospectively.The accuracy of preoperative high-resolution 3.0T MR in prediction of pathological staging was assessed,and the characteristic imaging features of local infiltration in preoperative rectal cancer were discussed.Results The relationship between circumference invasion of colorectal cancer and the pathological T staging was moderately positive （rs=0.530,P=0.003）.Compared the staging of colorectal cancer on MRI with pathologic T staging,the overall diagnostic accuracy was 84.52%,and there was a stronger correlation between MRI findings and pathological staging （rs=0.837,P=0.001）.The best single parameters for diagnosing T3 stage rectal cancer on MRI were nodular convex of the tumor and muscular signal interruption,with 91.1% specificity and 89.7% sensitively respectively.And the best combination of parameters was the cord appearence of intestinal wall and muscular signal interruption,with 89.3% specificity and 78.0% sensitively respectively.Conclusion High-resolution 3.0T MR can be preferable to evaluating local infiltration of rectal cancer, showing a higher clinical value to asseee T staging of preoperative rectal cancer.

关 键 词：直肠癌 局部浸润 磁共振成像 

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