MRI对食管癌T分期诊断及手术切除中的评估价值分析  

The Value of MRI in the Diagnosis T Stage and Valuation of the Effects of Surgical Resection of Esophageal Cancer

作　　者：秦福双[1] QING Fu-shuang(Puyang City Hospital in Anyang Region Puyang 455000,Henan Province,China)

机构地区：[1]河南省濮阳市安阳地区医院,河南濮阳455000

出　　处：《中国CT和MRI杂志》2018年第1期94-97,共4页Chinese Journal of CT and MRI

基　　金：国家自然科学基金资助项目编号:81272608

摘　　要：目的分析磁共振成像(MRI)对食管癌T分期诊断及手术切除中的评估价值。方法选取2013年6月至2015年2月我院收治的食管癌患者48例为研究对象,均行CT、MRI检查,观察食管癌不同T分期的MRI表现特点,进行术前TN分期,并以术后病理结果为准,比较MRI、CT诊断食管癌T分期的灵敏度、特异度、准确度及对区域淋巴结转移的准确率。结果 MRI显示病灶在MR-DWI上均呈高信号,T_(1-2)期病灶周边肌层线状低至中等信号影完整,T_3期病灶周边肌层线状低至中等信号影中断或消失,T_4期病灶与邻近结构间脂肪间隙消失并伴邻近结构受侵征象;MRI对食管癌T_(1-2)分期特异度90.00%、准确度79.17%高于CT 60.00%、58.33%(P<0.05),对T_(3-4)期病灶,CT、MRI的灵敏度、特异度、准确度比较无显著差异(P>0.05);MRI及CT对食管癌淋巴结N分期的诊断效能无显著差异(P>0.05)。结论 MRI在食管癌术前分期及手术评估中具有较高价值,尤其对T_1、T_2期的准确率较CT高,值得在临床推广应用。Objective To evaluate the value of magnetic resonance imaging(MRI)in the diagnosis of T stage and evaluation of the effects of surgical resection of esophageal carcinoma.Methods Forty-eight patients with esophageal cancer treated in our hospital between June 2013 and February 2015 were selected as the study subjects.All patients underwent CT and MRI examination,and the MRI features of esophageal cancerat different T stages were observed.TN staging was performed before surgery.With the postoperative pathological results as the standard,the sensitivity,specificity and accuracy in the diagnosis of T stage of esophageal cancer and the accuracy in the diagnosis of local lymph node metastases were compared between MRI and CT.Results MRI showed showed high signal on MR-DWI.In T1-2phase,the linear low to medium signal of muscle layersurrounding lesions was complete while in T3 phase,it was interrupted or disappeared,and in T4phase,fat spaces between lesions and adjacent structures disappeared with adjacent structures invasion.The specificity and accuracy of MRI in the diagnosis of esophageal cancer at T1-2 stage(90.00%,79.17%)were higher than those of CT(60.0%,58.33%)(P<0.05).There were no significant differences in the sensitivity,specificity and accuracy between MRI and CT in the diagnosis of T3-4 stage(P>0.05).There was no significant difference in the diagnostic efficacy between MRI and CT in N staging of esophageal cancer(P>0.05).Conclusion MRI is of high value in preoperative staging and evaluation of esophageal cancer,especially for T1 and T2.It is worth to be popularized and applied in clinical practice.

关 键 词：MRI 食管癌 T分期 诊断 

分 类 号：R735.1[医药卫生—肿瘤]