|
|
|
| Clinical application of high-resolution 3.0T MRI in preoperative staging of rectal cancer |
| YU Wen-qian1, CHANG Hong2, LI Hai-ling1, SHI Yu-zhu1, WANG Chun-li1,#br#
WANG Yu3, HAN De-chang3, LI Xiang-chun3, MA Meng-hua3 |
1. Department of Imaging Center, Hebei Yanda Hospital, Sanhe Hebei 065201, China;
2. Beijing Junqu Beidaihe Nursing Home, Qinhuangdao Hebei 066100, China;
3. MRI Room, Tangshan Gongren Hospital, Tangshan Hebei 063000, China |
|
|
|
|
Abstract Objective: To investigate the diagnostic value of high resolution 3.0T MRI conventional scan, DWI and DCE MR imaging in TNM staging of rectal cancer. Methods: Twenty-six male and thirty female patients(49~78 years old) with pathologically confirmed rectal cancer were enrolled between January 2013 to May 2016. The imaging sequences included plain sagittal T2WI, axial T2WI, T1WI, DWI, coronary T2WI, fat-suppressed axial and coronal T2WI, axial, sagittal and coronal sequences of T1WI were dynamically enhanced. The image quality of each sequence is evaluated. The results of preoperative MRI staging were compared with the results of postoperative pathological staging. Results: High-resolution MRI in 50 of 56 cases of rectal cancer showed correct T stage. Among the rest 6 cases, two cases of pathologically T1 and T3 were preoperatively misdiagnosed to be T2 respectively. Two cases of T2 were preopreatively misdiagnosed T1. The total coincidence rate was 89.2%(50/56). The coincidence rate of T1 stage was 75%(6/8). The coincidence rate of T2 stage was 91%(20/22). The coincidence rate of T3 stage was 91%(20/22). The coincidence rate of T4 stage was 100%(4/4). The accuracy of MRI in the diagnosis of total T stage were 89.2%(50/56), and the sensitivity and accuracy of combining each sequence in the diagnosis of rectal cancer were superior to that of routine sequence. The time-signal intensity curve of rectal cancer showed an outflow pattern. Dynamic contrast-enhanced scan was superior to other sequences in the detection of rectal cancer and invasion of the surrounding wall. Conclusion: The ideal combination of 3.0T MRI imaging sequences for rectal cancer consists of sagittal T2WI, axial T2WI, T1WI, DWI(b value of 1 000 s/mm2), coronary T2WI and axial, sagittal and coronary enhanced scan, which can be used for preoperative staging of rectal cancer.
|
|
Received: 26 August 2016
|
|
|
|
|
|
[1]陈孝平，汪建平. 外科学[M]. 8版. 北京：人民卫生出版社，2013：492.
[2]Samdani T, Garcia-Aguilar J. Imaging in rectal cancer: magnetic resonance imaging versus endorectal ultrasonography[J]. Surg Oncol Clin North Am, 2014, 23(1): 59-77.
[3]王晓阳，贾庆，蔡宇. 高分辨率MRI技术在直肠癌术前T分期中的应用[J]. 中国现代医生，2012，50（25）：87-89.
[4]Hunter CJ, Garant A, Vuong T, et al. Adverse features on rectal MRI identify a high-risk group that may benefit from more intensive preoperative staging and treatment[J]. Ann Surg Oncol, 2012, 19(4): 1199-1205.
[5]Bugg WG, Andreou AK, Biswas D, et al. The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma[J]. Clin Radiol, 2014, 69(6): 619-623.
[6]陈大伟. 直肠癌局部侵犯范围的术前判断[J]. 消化外科，2002，1（3）：160-162.
[7]卢爱国，周玮，尹华. 直肠腔内超声在低位直肠癌术前分期的作用[J]. 中国内镜杂志，2002，8（1）：17-18.
[8]唐娜，尚乃舰. 对直肠癌术前分期的诊断价值[J]. 实用放射学杂志，2013，29（4）：583-585.
[9]吴平. 直肠癌的影像学诊断进展[J]. 实用医院临床杂志，2012，9（6）：209-211.
[10]周欣，张婷婷. MRI技术在低位直肠癌研究中的新进展[J]. 中国介入影像与治疗学，2012，9（8）：637-640.
[11]容蓉，孙晓伟，王霄英，等. MRI和CT对原发性直肠癌术前N分期的诊断研究[J]. 实用放射学杂志，2011，27（10）：1495-1498；1534. |
|
|
|
