动态MRI成像技术在低位直肠癌患者术前盆底功能评估中的价值  

The Value of Dynamic MRI Imaging in Preoperative Assessment of Pelvic Floor Function in Patients with Low-grade Rectal Cancer

作　　者：顾程 张洁 马梦华 王余 申新宇 韩德昌 GU Cheng;Zhang Jie;MA Meng-hua;WANG Yu;SHEN Xin-yu;HAN De-chang(Department of Radiology,Tangshan Gongren Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]河北省唐山市工人医院影像中心,河北唐山063000

出　　处：《中国CT和MRI杂志》2023年第11期128-131,共4页Chinese Journal of CT and MRI

基　　金：河北省医学科学研究课题计划(20210787)。

摘　　要：目的探讨动态MRI成像技术在低位直肠癌患者术前盆底功能评估中的应用价值。方法前瞻性收集30例首次经肠镜活检确诊为低位直肠癌并行保肛手术的患者。受试患者均于术前行X线排粪造影、盆腔常规MRI及动态MRI检查。应用ICC和Pearson相关分析比较患者动态MRI检查与XRD的一致性及相关性。结果动态MRI与XRD在ARA的测量上一致性较高,静息相ICC=0.891、提肛相ICC=0.847、力排相ICC=0.940,且差异有统计学意义(P<0.001)。动态MRI上PR-T、EAS-T、IAS-T与XRD上ARA存在负相关,静息相r=-0.436、-0.414、-0.447,提肛相r=-0.427、-0.409、-0.387,力排相r=-0.442、-0.470、0.467,且差异有统计学意义(P<0.05)。动态MRI上ARA、M-L与XRD上DUAC存在正相关,静息相r=0.506、0.425,提肛相r=0.391、0.429,力排相r=0.437、0.379;动态MRI上PR-T、EAS-T(静息和提肛相)与XRD上DUAC存在负相关,静息相r=-0.458、-0.430,提肛相r=-0.383、-0.404,力排相r=-0.454,以上差异均有统计学意义(P<0.05)。结论在对低位直肠癌患者术前盆底功能的评估中,动态MRI检查与XRD相关观测指标的一致性和相关性较高,是指导临床进行全面、准确术前评估的首选影像学检查方法。Objective To explore the value of dynamic MRI imaging in assessing preoperative pelvic floor function in patients with low rectal cancer.Methods 30 patients firstly diagnosed low rectal cancer by colonoscopic biopsy and underwent anal preservation surgery were prospectively entolled in this study.All patients underwent X-ray defecography,pelvic routine and dynamic MRI scan.Intra-class correlation coefficient(ICC)and pearson correlation analysis were used to compare consistency and relevance between dynamic MRI imaging and XRD.Results The consistency of ARA was high between dynamic MRI and XRD,the value of ICC in resting phase,lifting phase and defecation phase were 0.891,0.847,0.940 respectively,and the difference was statistically significant(P<0.001).There were negative correlations between PR-T,EAS-T,IAS-T of dynamic MRI and ARA of XRD,the value of r in resting phase were-0.436,-0.414,-0.447 respectively,in lifting phase were-0.427,-0.409,-0.387 respectively,and in defecation phase were-0.442,-0.470,0.467 respectively.The difference was statistically significant(P<0.05).There were positive correlations between ARA,M-L of dynamic MRI and DUA C of XRD,the value of r in resting phase were 0.506,0.425 respectively,in lifting phase were 0.391,0.429 respectively,and in defecation phase were 0.437,0.379 respectively.There were negative correlations between PR-T,EAS-T(just in resting phase and lifting phase)of dynamic MRI and DUA C of XRD,the value of r in resting phase were-0.458,-0.430 respectively,in lifting phase were-0.383,-0.404 respectively,and in defecation phase were-0.454.All the differences were statistically significant(P<0.05).Conclusion The consistency and correlation were high between dynamic MRI and XRD of preoperative pelvic floor function in patients with low-grade rectal cancer,and making dynamic MRI the preferred imaging method for guiding a comprehensive and accurate preoperative clinical evaluation.

关 键 词：动态MRI检查 X线排粪造影 低位直肠癌 盆底功能 保肛手术 

分 类 号：R445.2[医药卫生—影像医学与核医学]