直肠灌水磁共振成像在直肠癌诊断及术前分期中的应用
The value of MRI with rectal irrigation in diagnosis and preoperative staging of rectal cancer
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摘要: 目的:探讨直肠灌水磁共振成像(MRI)在直肠癌诊断及术前分期中的应用价值。方法:对32例临床拟诊直肠癌患者术前行直肠灌水MRI检查,每例患者均常规行横断面和矢状面T1WI、T2WI;10例患者加做直肠MRI水成像,观察肿瘤特征及周边浸润、淋巴结增大情况,并将检查结果与手术病理对照。结果:直肠灌水MRI扫描对直肠癌T分期总的诊断准确性为87.5%,T2、T3和T4期诊断准确性分别为78.6%、93.3%、100.0%;诊断淋巴结转移的敏感性为56.5%,特异性为98.4%;水成像能清楚显示直肠癌形态、大小、位置及肠腔狭窄程度。结论:直肠灌水MRI成像能较准确对直肠癌进行术前分期,有助于合理治疗方案的制定和预后评估,MRI水成像是常规扫描序列的补充。Abstract: Objective:To investigate the value of MRI with rectal irrigation in diagnosis and preoperative staging of rectal cancer.Methods:Thirty-two patients with suspected rectal cancer were detected by MRI with rectal irrigation.All patients were scaned under T1WI and T2WI of axial and sagittal plane.Ten cases were detected through MRI with rectal irrigation.The tumor characteristics,surrounding infiltrating and lymph node enlargement were measured,which were compared with pathology.Results:The overall diagnosis accuracy of T staging by MRI with rectal irrigation was 87.5% and the diagnosis accuracy of less than or equal to T2,T3 and T4 were 78.6%,93.3% and 100.0%,respectively.The sensitivity and specificity of lymph nodes invasion were 56.5% and 98.4%.The shape,size and position of rectal neoplasms and stricture of rectal lumen could be clearly displayed under MRI.Conclusions:MRI with rectal irrigation can accurately judge the preoperative stage of rectal neoplasms,which can help to make reasonable treatment and prognosis assessment.It is a supplement for routine scan.