摘要
目的:探讨磁共振(MRI)水成像(MRH)对直肠癌术前诊断和分期的价值.方法:对临床确诊为直肠癌的患者34例进行MRI水成像检查,检查前经直肠注入生理盐水300 mL左右,先作盆腔常规轴位平扫,再作磁共振直肠水成像扫描,扫描完后再作轴位、矢状位和冠状位增强扫描.结果:34例直肠癌均能显示原发病灶,三维成像病变部位肠腔内不规则充盈缺损32例.19例病变远侧端呈"袖口征"及"截断征".轴位30例表现为腔内软组织肿块,26例表现为肠壁不规则增厚,肠腔环形狭窄.MRI水成像检查对T1,T2,T3,T4期肿瘤的准确度分别为66.7%(2/3),76.9%(10/13),86.7%(13/15),100%(3/3),总准确性为82.4%(28%34);判断淋巴结转移的敏感性、特异性和准确性分别为69.2%(18/26),62.5%(5/8),67.6%(23/34);对邻近组织脏器浸润、远处转移判断的准确度分别为94.1%(32/34)、97.1%(33/34).结论:MRI水成像加常规平扫加增强扫描对直肠癌的诊断和分期有较大价值,可以较准确地判断肿瘤在肠壁的浸润深度及盆腔内淋巴结的转移.
AIM： To explore the value of rectal magnetic resonance hydrography （MRH） in rectal carcinoma. METHODS： Thirty-four patients with rectal carcinoma were included in the study. All underwent plain scan, three-planar enhanced scan and hydrography. RESULTS： All foci were correctly detected by rectal MRH, which showed that there were irregular intraluminal filling defects （n = 32）, and that ＂cuff＂ or ＂sawn-off＂ signs were seen at the distal end of the tumor （n = 19）. Main MRH findings were： intraluminal soft tissue mass （n = 30）, irregular thickening of the rectal wall and partial or circumferential stenosis of the rectal lumen （n = 26）. The accuracy of rectal MRH for T staging was 82.4% （28/34）. The accuracy for T1, T2, T3, and T4 staging was 66.7% （2/3）, 76.9% （10/13）, 86.7% （13/15） and 100% （3/3）, respectively. The sensitivity, specificity, and accuracy for lymph node metastases were 69.2% （18/26）, 62.5% （5/8） and 67.6% （23/34）, respectively. The accuracy for adjacent organ invasion and liver metastasis was 94.1% （32/34） and 97.1% （33/34）, respectively. CONCLUSION： The combination of MRI plain scan, three-planar enhanced scan and hydrography could accurately stage rectal carcinomas and determine the invasive depth of local lesions. This method has direct applicability for clinical treatment.
出处
《世界华人消化杂志》
CAS
北大核心
2007年第17期1928-1933,共6页
World Chinese Journal of Digestology
基金
福建省自然科学基金
No C0410044
关键词
直肠癌
分期
磁共振水成像
Rectal carcinoma
Staging
Hagnetic resonance hydrography
作者简介
涂小煌，中国人民解放军第四军医大学博士生，主任医师．主要从事消化道肿瘤防治研究．
通讯作者：黎成金，350025，福建省福州市．中国人民解放军南京军区福州总医院普通外科．lichengjin@yahoo．com．cn电话：0591-22859415传真：0591-8379685
