Yamada Ichiro, Okabe Satoshi, Enomoto Masayuki, Sugihara Kenichi, Yoshino Norio, Tetsumura Akemi, Kumagai Jiro, Shibuya Hitoshi
Department of Diagnostic Radiology and Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Radiology. 2008 Feb;246(2):444-53. doi: 10.1148/radiol.2462070128. Epub 2007 Dec 19.
To retrospectively assess the accuracy of high-spatial-resolution three-dimensional (3D) constructive interference in steady-state (CISS) magnetic resonance (MR) imaging in the evaluation of mural invasion of colorectal carcinoma by using prospectively obtained in vitro images, with histopathologic analysis as the reference standard.
Institutional review board approval was obtained for the prospective and retrospective components of this study, with informed consent for the former and waiver of informed consent for the latter. Surgical specimens were obtained in 92 patients (61 men, 31 women; mean age, 65 years) and contained 96 colorectal carcinomas. Specimens were examined with a 1.5-T MR system and a 4-cm-diameter loop coil. High-spatial-resolution 3D CISS MR images were obtained with 80 x 80-mm field of view, 512 x 512 matrix, and 0.7-mm section thickness, which resulted in a 0.017-mm(3) voxel size. The 3D data sets were postprocessed with surface-rendering software to generate virtual MR endoscopic images. The 3D CISS MR images were compared with histopathologic findings, and virtual MR endoscopic images were compared with macroscopic findings at surgery. Statistical analysis was performed with Spearman rank correlation.
In 92 (96%) colorectal carcinomas, the depth of mural invasion depicted by 3D CISS MR imaging correlated well with the histopathologic stage, although the stage assigned with 3D CISS MR imaging was higher than that assigned with histopathologic analysis in four (4%) carcinomas (r = 0.976, P < .001). Sensitivity, specificity, and accuracy were 100%, 94%-96%, and 98%-100%, respectively. In 91 (95%) carcinomas, virtual MR endoscopy clearly depicted the macroscopic type of carcinoma, including gross configuration and tumor ulceration (r = 0.916, P < .001).
High-spatial-resolution 3D CISS MR imaging has high diagnostic accuracy in the in vitro evaluation of mural invasion and macroscopic features of colorectal carcinomas.
通过前瞻性获取的体外图像，以组织病理学分析为参考标准，回顾性评估高空间分辨率三维（3D）稳态构成干扰序列（CISS）磁共振（MR）成像在评估结直肠癌壁层侵犯方面的准确性。
本研究的前瞻性和回顾性部分均获得机构审查委员会批准，前者获得知情同意，后者豁免知情同意。收集了92例患者（61例男性，31例女性；平均年龄65岁）的手术标本，其中包含96个结直肠癌。标本采用1.5-T MR系统和直径4 cm的环形线圈进行检查。采用80×80 mm视野、512×512矩阵及0.7 mm层厚获取高空间分辨率3D CISS MR图像，体素大小为0.017 mm³。利用表面渲染软件对3D数据集进行后处理以生成虚拟MR内镜图像。将3D CISS MR图像与组织病理学结果进行比较，将虚拟MR内镜图像与手术中的宏观表现进行比较。采用Spearman等级相关性进行统计分析。
在92个（96%）结直肠癌中，3D CISS MR成像显示的壁层侵犯深度与组织病理学分期相关性良好，尽管在4个（4%）癌中，3D CISS MR成像确定的分期高于组织病理学分析确定的分期（r = 0.976，P <.001）。敏感性、特异性和准确性分别为100%、94% - 96%和98% - 100%。在91个（95%）癌中，虚拟MR内镜清晰显示了癌的宏观类型，包括大体形态和肿瘤溃疡（r = 0.916，P <.001）。
高空间分辨率3D CISS MR成像在体外评估结直肠癌壁层侵犯和宏观特征方面具有较高的诊断准确性。
