摘要
目的探讨MRI常规扫描、弥散加权成像及动态增强扫描在直肠癌术前分期的诊断价值。方法将直肠癌术前MRI的分期结果形成“DISTANCE”评估结果与术后病理分期结果对比,以手术后病理分期来评价MRI在直肠癌术前分期和病理分期结果的一致性。结果在肿瘤下段距离肛缘的距离、肿瘤侵犯深度、肛门复合体、直肠环周切缘及肌层外血管侵犯评估中弥散加权成像及动态增强扫描均具有好的一致性,常规MRI仅具有较好的一致性,弥散加权成像及动态增强扫描差异无统计学意义;在淋巴结评估中,弥散加权成像及动态增强扫描具有较好的一致性,常规MRI具有较差的一致性,动态增强扫描优于弥散加权成像。结论弥散加权成像及动态增强扫描在直肠癌的术前分期均显著优于常规MRI,可应用于直肠癌的术前评估,弥散加权成像及动态增强扫描各有优缺点,临床上应视具体情况选择弥散加权成像或者动态增强扫描的进行直肠癌的术前评估。
Objective To investigate the diagnostic value of routine MRI,diffusion-weighted imaging and dynamic contrast-enhanced scanning in preoperative staging of rectal cancer.Methods The preoperative MRI staging results of rectal cancer were formed into the “DISTANCE” evaluation results,which were compared with those of postoperative pathological staging.The consistency of MRI in preoperative staging and pathological staging of rectal cancer was evaluated by postoperative pathological staging.Diffusion-weighted imaging and dynamic enhancement scan were well consistent in the evaluation of the distance from the lower tumor to the anal margin,tumor invasion depth,anal complex,rectal circumferential resection,and extramyometric vascular invasion.Results The diffusion-weighted imaging and dynamic contrast-enhanced scanning showed good consistency in the evaluation of the distance from the lower segment of the tumor to the anal margin,the depth of tumor invasion,the anal complex,the rectal circumferential margin and the extramedullary vascular invasion,while the conventional MRI showed only comparatively good consistency.There was no significant difference between diffusion weighted imaging and dynamic enhanced scanning in terms of good consistency,diffusion-weighted imaging and dynamic enhanced scanning had good consistency in the evaluation of lymph node,while conventional MRI had poor consistency.Dynamic enhanced scanning was better than dispersion-weighted imaging.Conclusion Diffusion-weighted imaging and dynamic contrast-enhanced scanning are superior to conventional MRI in preoperative staging of rectal cancer.It can be used for preoperative evaluation of rectal cancer.Diffusion-weighted imaging and dynamic enhanced scanning have their own advantages and disadvantages.Preoperative assessment of rectal cancer should be performed by diffusion-weighted imaging or dynamic enhanced scanning,depending on specific clinical conditions.
作者
何伟荣
连永伟
李思荣
廖志东
颜显杰
He Weirong;Lian Yongwei;Li Sirong;Liao Zhidong;Yan Xianjie(Medical Imaging Department,Meizhou Chinese Medicine Hospital;Medical General Surgery,Meizhou Chinese Medicine Hospital;Pathology Department,Meizhou Chinese Medicine Hospital,Meizhou 514071 China)
出处
《锦州医科大学学报》
CAS
2019年第4期33-35,41,共4页
Journal of Jinzhou Medical University
基金
2018年度梅州市医药卫生科研课题,项目编号:2018-B-58
