功能MRI成像对低位前切除综合征的研究价值  

The Research Value of Functional MRI Imaging in Low Anterior Resection Syndrome

作　　者：顾程 申新宇 唐宇杰 张洁 韩德昌 GU Cheng;SHEN Xin-yu;TANG Yu-jie;ZHANG Jie;HAN De-chang(Department of Radiology,Tangshan Gongren Hospital,Tangshan 063000,Hebei Province,China)

机构地区：[1]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》2024年第9期149-152,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：目的探究功能MRI成像技术在评估低位直肠癌保肛术后低位前切除综合征中的应用价值。方法收集低位直肠癌保肛术后的患者38例,所有患者于术后第3个月内行盆腔功能MRI成像,并采用LARS评分表进行评分。将无LARS症状的患者纳入阴性组,轻度和重度LARS症状的患者纳入阳性组,阳性组患者均于盆腔功能MRI检查的1周内行3D HR-ARM检查。比较LARS阳性组和阴性组功能MRI检查间的差异,分析LARS阳性组功能MRI检查和3D HR-ARM检查间的相关性。结果LARS阳性组各时相的PR厚度和EAS厚度均小于阴性组,且差异有统计学意义(P<0.05)。功能MRI成像与3D HR-ARM检查相关性分析显示:静息相的H线长度与RAPD呈正相关,静息相的EAS厚度与MSP呈正相关,力排相的H线长度与IRP呈正相关,三时相的PR厚度与HPZ呈正相关,提肛相的IAS厚度与IRP和RAPD呈负相关(P<0.05)。结论低位直肠癌患者PR和EAS受损、功能减退是影响术后出现LARS的重要因素,功能MRI成像可清晰显示盆底解剖结构变化,与3D HR-ARM检查相结合,可对LARS患者进行全面评估和疗效监测。Objective To explore the application value of functional MRI imaging technology in the evaluation of low anterior resection syndrome after anus-preserving surgery for low rectal cancer.Methods 38 patients with low rectal cancer underwent anus-preserving surgery were collected.All patients underwent pelvic functional MRI imaging within the third month after surgery and were scored using the LARS scale.Patients without LARS symptoms were included in the negative group,and patients with mild and severe LARS symptoms were included in the positive group.All patients in the positive group underwent 3D HR-ARM examination within 1 week of the pelvic functional MRI examination.Compare the differences between functional MRI examination in the LARS positive group and the negative group,and analyze the correlation between functional MRI examination and 3D HR-ARM examination in the LARS positive group.Results The PR thickness and EAS thickness of each phase in the LARS positive group were smaller than those in the negative group,and the difference was statistically significant(P<0.05).Correlation analysis between functional MRI imaging and 3D HR-ARM examination showed that:the H-line length in the resting phase was positively correlated with RAPD,the EAS thickness in the resting phase was positively correlated with MSP,the H-line length in the forceful phase was positively correlated with IRP,the PR thickness of the three phases was positively correlated with HPZ,and the IAS thickness of the levator phase was negatively correlated with IRP and RAPD(P<0.05).Conclusion Impairment and functional decline of patients'PR and EAS with low rectal cancer are important factors affecting the occurrence of LARS after surgery.Functional MRI imaging can clearly display changes in the anatomical structure of the pelvic floor.Combined with 3D HR-ARM examination,it can comprehensively evaluate and monitor the efficacy of LARS patients.

关 键 词：功能MRI成像 3D高分辨直肠肛门测压 低位前切除综合征 低位直肠癌 盆底功能 

分 类 号：R445.2[医药卫生—影像医学与核医学]