磁共振成像对直肠癌患者术后局部复发的临床诊断价值  

Magnetic resonance imaging for diagnosing postoperative local recurrence of rectal cancer

作　　者：张玉英[1] 马骏[2] 

机构地区：[1]沈阳医学院附属中心医院放射线科,沈阳110024 [2]沈阳医学院附属中心医院普外四科,沈阳110024

出　　处：《中国肿瘤临床与康复》2017年第12期1469-1471,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨磁共振成像对直肠癌患者术后局部复发的临床诊断效果。方法选取2015年5月至2017年5月间沈阳医学院附属中心医院收治的90例直肠癌术后局部复发的患者,均接受直肠癌根治术+常规化疗。采用磁共振成像(MRI)与电子计算机断层扫描(CT)进行诊断,比较两种方法诊断直肠癌患者术后局部复发的准确性、特异性及灵敏性。结果 MRI诊断直肠癌患者术后复发的准确性、灵敏性和特异性分别为91.1%、86.7%和73.3%,CT诊断分别为75.6%、66.7%和60.0%,MRI较CT诊断结果均较高,差异均有统计学意义(均P<0.05)。直肠癌患者术后局部复发的MRI征象为:骶前分叶状肿块,T1WI呈低信号,T2WI及弥散加权(DWI)呈高信号,增强扫描不均匀或环形强化。CT征象为:骶前出现密度分布不均的团组织肿块,增强扫描可见中心坏死、边缘高低不平的环状强化,吻合口出处不规则增厚,腔隙变窄,伴有盆腔组织受累。结论 MRI诊断直肠癌患者术后局部复发相比CT,具有较高的准确性及灵敏性,为术后复发的治疗可提供合理依据。Objective To explore and analyze the effectiveness of magnetic resonance imaging（ MRI） for diagnosing postoperative local recurrence of rectal cancer. Methods From May 2015 to May2017,90 patients with postoperative local recurrence of rectal cancer treated at Affiliated Hospitals to Shenyang Medical College were selected. All the patients received radical resection of rectal cancer and routine chemotherapy. Computer tomography（ CT） and MRI diagnosis were performed. The accuracy,specificity and sensitivity of the two diagnostic methods were compared for postoperative local recurrence of rectal cancer. Results The accuracy,specificity and sensitivity of MRI was 91. 1%,86. 7% and 73. 3%,respectively,which was higher than 75. 6%,66. 7% and 60. 0%,respectively of CT in the diagnosis of postoperative local recurrence of rectal cancer. The MRI indication for postoperative local recurrence of rectal cancer included lobulated sacral mass,T1 WI low signal,T2 WI and diffusion weighted（ DWI） high signal,uneven enhancement scan or circular reinforcement. The CT indication for postoperative local recurrence of rectal cancer included sacral mass of uneven density,center necrosis,circular reinforcement with rough edge,irregular thickening of anastomosis and narrow lumens complicated with pelvic tissue involvement.Conclusion Compared with CT in the diagnosis of postoperative rectal cancer local recurrence,MRI has high accuracy and sensitivity and can provide reasonable basis for the treatment of postoperative recurrent rectal cancer.

关 键 词：磁共振成像 直肠肿瘤 术后局部复发 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]