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高分辨磁共振评估直肠癌术前系膜筋膜受累的临床价值
李维,母其文,张福洲,何孔明,蒋炳虎,郭达,杨选华,任明杨
0
(南充市中心医院·川北医学院第二临床医学院影像科;南充市中心医院·川北医学院第二临床医学院胃肠外科)
摘要:
【摘要】目的 探讨高分辨磁共振(MRI)评估直肠癌术前系膜筋膜(MRF)有无累及的临床价值,以指导直肠癌治疗方式的选择。方法 收集我院2015年~2019年76例经病理证实的进行盆腔磁共振检查的76例直肠癌患者,MRI常规扫描序列包括失状位FRFSE T2WI、斜冠状位FRFSE T2WI、斜轴位FRFSE T2WI。结合所有序列对直肠癌做出术前T、N分期,评估直肠系膜筋膜有无受侵,然后与病理结果TN分期进行对照。结果 在76例直肠癌中,T分期中磁共振术前诊断正确64例,错误12例,准确率为842%。N分期中磁共振术前诊断正确52例,错误24例,准确率为684%。MRI判断MRF有无侵犯的准确率、特异度、敏感度、阴性预测值及阳性预测值分别为934%、947%、900%、963%及857%。结论 高分辨率磁共振成像可对直肠癌术前的系膜筋膜有无侵犯进行精准评估,还可做出准确的局部分期,用于指导临床治疗及判断预后。
关键词:  磁共振成像  高分辨  直肠癌  直肠系膜筋膜
DOI:
基金项目:四川省医学科研课题计划(S15049);南充市科技局课题(15A0088)
The clinical value of high resolution magnetic resonance in preoperative assessment of mesorectal fascia involvement of rectal cancer
LI Wei,MU Qiwen,ZHANG Fuzhou,HE Kongming,JIANG Binghu,GUO Da,YANG Xuanhua,REN Mingyang
(Department of Radiology, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital;Department of Gastrointestinal Surgery, The Second Clinical Medical College of North Sichuan Medical College,Nanchong Central Hospital)
Abstract:
【Abstract】Objective The purpose of this study was prospectively to evaluate the preoperative invasion of mesorectal fascia of rectal cancer with high resolution MRI and guide the multidisciplinary diagnosis and individual treatment of patients with rectal cancer.Methods From 2015 to 2019, 76 cases of rectal cancer confirmed by pathology in our hospital were collected. The routine MRI sequences included loss of shape frfse T2WI, oblique coronal frfse T2WI and oblique axial frfse T2WI. Combined with all sequences, preoperative T and N stages of rectal cancer were made to evaluate whether the mesorectum fascia was invaded, and then compared with the pathological results of TN stage.Results In 76 cases of rectal cancer, 64 cases were correctly diagnosed and 12 cases were wrong in T staging, the accuracy rate was 842%. In N staging, 52 cases were correctly diagnosed and 24 cases were wrong, the accuracy was 684%. The accuracy, specificity, sensitivity, negative predictive value and positive predictive value of MRI were 934%, 947%, 900%, 963% and 857%, respectively.Conclusion High resolution MRI enables accurately preoperative assessment MRF infiltration in rectal cancer and can carry on the local stage accurately.
Key words:  Magnetic resonance imaging  High resolution  Rectal cancer  Mesorectal fascia

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