直肠系膜淋巴结影像与病理定位方法的研究现状  

Research status of mesenteric lymph node imaging and pathologic localization

作　　者：贾玉萍 李盼盼 吴瑞 洪宇 宋歌声 JIA Yuping;LI Panpan;WU Rui;HONG Yu;SONG Gesheng(Department of Radiology,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,China;Department of Radiology,Shandong Procincial Qianfoshan Hospital,Shandong University,Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)放射科,济南250014 [2]山东大学附属千佛山医院放射科,济南250014

出　　处：《磁共振成像》2022年第8期162-165,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：山东省科技发展计划项目(编号:2014GSF118086);济南市科技计划(后补助)项目(编号:201907034)。

摘　　要：直肠癌是常见的消化道恶性肿瘤,近年来发病率逐渐提高,发病年龄也趋于年轻化。淋巴结转移是直肠癌常见的转移方式,与患者术后复发和转移密切相关,其中直肠系膜内淋巴结是其最常见也是最容易发生转移的区域淋巴结。直肠系膜内准确的淋巴结定性不仅可以获得准确的淋巴结分期、评估全系膜切除手术的环周切缘情况,还可以提供直肠癌复发风险信息,从而综合评估患者预后。因此,术前诊断直肠系膜内淋巴结的转移情况非常有意义。但目前淋巴结诊断比较困难,除了转移性淋巴结和非转移性淋巴结在影像学表现上的重叠性外,主要是术后解剖结构的改变导致了影像与病理淋巴结定位困难,从而导致术前诊断与术后验证的准确性降低。实现直肠癌淋巴结的影像学与病理对应是提高术前诊断转移淋巴结的关键。本文主要总结了直肠淋巴结的影像与病理对应方法,通过对比每种方法的利弊,以寻找一个简单可靠的对术前影像学和术后标本淋巴结进行验证的方法。Rectal carcinoma is a common malignant tumor of digestive tract. The incidence rate has gradually increased in recent years,and the age of onset is also younger. Lymph node metastasis is a common way of metastasis of rectal cancer, and is closely related to postoperative recurrence and metastasis. Mesorectal lymph nodes are the most common and prone to metastasis. At the same time,mesenteric lymph node metastasis also affects the evaluation of circumferential margin. Therefore, preoperative diagnosis of mesenteric lymph node metastasis has very high clinical significance. However, at present, the diagnosis of lymph nodes is difficult. In addition to the overlap between metastatic and non-metastatic lymph nodes, the main point is the difficulty of postoperative lymph node follow-up.The changes of postoperative anatomical structure lead to the difficulty of image pathological lymph node location, resulting in the reduction of the accuracy of preoperative diagnosis and postoperative verification. Realizing the correspondence between imaging and pathology of mesorectal lymph nodes of rectal cancer is the key to improve the preoperative diagnosis of metastatic lymph nodes. This paper mainly summarizes the imaging and pathological corresponding methods of mesorectal lymph nodes. By comparing the advantages and disadvantages of each method, we can find a simple and reliable method to verify the preoperative imaging and postoperative lymph nodes.

关 键 词：直肠癌 直肠系膜 淋巴结 区域转移 影像病理对应 准确性 预后 磁共振成像 

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] R735.4[医药卫生—临床医学]