MRI评估直肠癌淋巴结转移的价值  

The value of MRI for assessment of lymph node metastasis in rectal cancer

作　　者：刘丹[1] 张菁[1] 杨岚清[1] 伍兵[1] LIU Dan;ZHANG Jing;YANG Lanqing;WU Bing(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《国际医学放射学杂志》2019年第3期326-330,共5页International Journal of Medical Radiology

摘　　要：淋巴结转移是预测直肠癌预后的最重要因素,准确评估淋巴结有无转移有助于临床制定更合理的治疗方案。常规MRI主要依靠淋巴结大小诊断淋巴结性质,准确性不高。扩散加权成像(DWI)能够敏感地发现淋巴结,但转移性淋巴结与非转移性淋巴结的ADC值有部分重叠。动态增强MRI(DCE-MRI)定量分析能反映淋巴结微环境情况,有利于鉴别淋巴结性质。超微超顺磁性氧化铁-MRI(USPIO-MRI)可以诊断淋巴结性质且诊断敏感度较高,但尚未应用于临床。就常规MRI、DWI、DCE-MRI、USPIO-MRI对直肠癌淋巴结转移的诊断价值予以综述。Lymph node metastasis is the strongest prognostic factor associated with a worse prognosis in patients with rectal cancer.An accurate assessment of lymph node involvement helps to plan a more reasonable treatment.The accuracy of lymph node status mainly defined by the nodal size on conventional MRI is poor.DWI is sensitive to detect nodes,while the ADC values of metastatic and non-metastatic lymph nodes overlap partly.Quantitative DCE-MRI,which has great potential in judging the character of lymph nodes,can provide the information of nodal micro-environments.USPIO-MRI can be used to define the nodal status with higher diagnostic sensitivity,but has not been used in clinical practice.This article reviews the the applications of conventional MRI,DWI,DCE-MRI,and USPIO-MRI in evaluating lymph node status in rectal cancer.

关 键 词：直肠肿瘤 淋巴结 磁共振成像 扩散加权成像 动态增强磁共振成像 超微超顺磁性氧化铁-磁共振成像 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]