摘要
目的 通过比较分析MR平扫与增强扫描在直肠癌分期及肿瘤外侵程度判断上的准确性 ,期望对单纯MR平扫与MR平扫加增强扫描在直肠癌的应用作出评价。方法 收集了 1999年 9月至 2 0 0 2年 5月间临床诊断为直肠癌行MRI直肠检查 ,并有手术病理结果的病例共 3 3例。采用MR平扫与薄层增强扫描等多个序列来观察直肠癌的外侵程度与范围。并应用直肠癌的TNM分期标准对MR成像与手术病理结果进行对照分析。结果 直肠癌的分期 :在手术及病理诊断肿瘤限于黏膜下层以内的 6例T1期肿瘤中MRI作出了准确诊断 5例 ,1例高估为T2期 ,故其敏感性为 10 0 %、特异性为 83 .3 %。其中在平扫T1、T2加权像时有 2例认为T2期 ,但 3D薄层增强成像 1例作出了准确判断 ,1例仍判断错误 (假阳性 )。T3期的 2 3例中 ,MRI平扫T1和T2加权像时诊断正确的 2 1例 ,2例假阴性低估为T2期 ,其敏感性为 91.3 % ,特异性为 10 0 %。而有薄层增强扫描的 18例病人其诊断均与手术病理结果相符合。敏感性和特异性均为 10 0 %。T4期的病例共 4例 ,MRI平扫与增强扫描均与手术及病理所见相符合 ,其敏感性与特异性均为 10 0 %。MRI总的分期准确率为90 .9%。结论 MRI平扫加增强扫描对于直肠癌的术前分期及对肿瘤外侵深度的判断有较重要的临床应用价值。
Objective To evaluate the application values and accuracy between only non-enhancement and combination of non-enhanced and enhanced MRI in rectal cancer staging and detecting the depth of extramural tumor infiltration. Methods Thirty-three consecutive patients with a diagnosis of rectal carcinoma were examined using non-enhanced or/and enhanced MRI before surgery. The extent and depth of tumors were observed by multi-sequences of MRI including T1,T2 weighted imaging and thin-section gadolinium-DTPA enhanced 3D gradient imaging. The rectal cancer stage was made according to the TNM classification criteria. Results Among the six patients of T1 stage, 5 cases were correctly diagnosed in MR imaging. One case was estimated to T2 stage. However, 2 of 6 cases were over staging T2 in T1 and T2 weighted images, and only one of six was overestimated to T2 stage. MR imaging had 100% sensitivity and 83% specificity in T1 tumors. Non-enhanced MR imaging had a correct diagnosis of T3 tumors in 21 of all 23 patients. 2 of 23 cases were underestimated T2 tumors. The sensitivity and specificity of non-enhanced MR imaging in T3 was 91.3% and 100% respectively. All of 18 cases with non-enhanced and thin-thick enhancement of 3D gradient echo MR imaging showed correct staging in T3 tumors, with 100% sensitivity and specificity. Accuracy of rectal cancer staging of MR imaging in all 33 cases reached 90.9%. Conclusion Combination of non-enhanced or/and enhanced MR imaging can accurate stage rectal carcinoma and provide more information of the depth of tumor infiltration than do only non-enhanced MR imaging.
出处
《中国医学影像技术》
CSCD
2003年第5期585-587,共3页
Chinese Journal of Medical Imaging Technology
