Ferri M, Laghi A, Mingazzini P, Iafrate F, Meli L, Ricci F, Passariello R, Ziparo V
Department of Surgery P.Valdoni, University of Rome - La Sapienza, Rome, Italy.
Colorectal Dis. 2005 Jul;7(4):387-93. doi: 10.1111/j.1463-1318.2005.00787.x.
Pre-operative staging of rectal cancer should identify patients with extrarectal spread, who might benefit from pre-operative radiotherapy, and patients with minimal sphincteral involvement, who can avoid permanent colostomy. The aim of this study was to assess the accuracy of Magnetic Resonance Imaging (MRI) to predict tumour stage and sphincter status.
Thirty-three patients with a rectal tumour were pre-operatively assessed by MRI with a phased-array coil. Imaging results were correlated with the final pathological findings.
The overall accuracy of pre-operative staging with MRI was 88% (k = 0.75) for extramural tumour invasion and 59% (k = 0.26) for lymph node metastases. MRI correctly evaluated the infiltration of the anal sphincters in 87% of patients (7 of 8 patients with low rectal tumour).
MRI provides the surgeon with valuable information regarding extramural tumour spread and sphincteral involvement, enabling appropriate selection of patients for pre-operative adjuvant therapy or sphincter-saving surgery.
直肠癌的术前分期应识别出存在直肠外扩散、可能从术前放疗中获益的患者，以及括约肌受累程度最小、可避免永久性结肠造口术的患者。本研究的目的是评估磁共振成像（MRI）预测肿瘤分期和括约肌状态的准确性。
33例直肠肿瘤患者术前采用相控阵线圈进行MRI评估。影像学结果与最终病理结果进行对比。
MRI术前分期对壁外肿瘤侵犯的总体准确率为88%（k = 0.75），对淋巴结转移的准确率为59%（k = 0.26）。MRI正确评估了87%患者的肛门括约肌浸润情况（8例低位直肠肿瘤患者中的7例）。
MRI为外科医生提供了有关壁外肿瘤扩散和括约肌受累的有价值信息，有助于为患者合理选择术前辅助治疗或保留括约肌手术。
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