Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, 250 Seongsan-no, Seodaemun-gu, Seoul 120-752, Republic of Korea.
Radiology. 2010 Feb;254(2):485-92. doi: 10.1148/radiol.09090587.
To compare the local-regional staging accuracy of the conventional two-dimensional (2D) T2-weighted imaging protocol and of the three-dimensional (3D) T2-weighted imaging protocol for preoperative magnetic resonance (MR) imaging in rectal cancer patients.
This retrospective study was approved by the institutional review board, and a waiver of informed consent was obtained. A review was conducted of 109 preoperative 3-T MR images obtained with 2D and 3D T2-weighted imaging protocols in rectal cancer patients. Two radiologists independently assessed the radiologic findings for T and N category lesions, conspicuity of tumor margin, and image quality of 2D and 3D data. Interactive multiplanar reconstruction was performed for 3D data analysis. The linear weighted kappa values for T2-weighted imaging staging results (2D and 3D data) and histopathologic staging results were calculated and compared. Wilcoxon signed rank test was performed to compare tumoral conspicuity and overall image quality.
T category lesion staging accuracy values for 2D and 3D data, respectively, were 66.0% and 67.0% for reviewer 1 (P = .465) and 63.3% and 56.9% for reviewer 2 (P = .402). N category lesion staging accuracy values for 2D and 3D T2-weighted images, respectively, were 64.2% and 57.8% for reviewer 1 (P = .427) and 47.7% and 62.4% for reviewer 2 (P = .666). Tumor conspicuity was better for 2D T2-weighted imaging, but no significant difference in image quality was observed.
Preoperative MR imaging in rectal cancer patients for staging with conventional 2D and multiplanar reconstruction 3D T2-weighted imaging protocols showed no significant differences in accuracy of T and N category staging and overall image quality, as determined by degree of artifact. However, the 3D T2-weighted imaging protocol had limitations in regard to lesion conspicuity.
比较常规二维（2D）T2 加权成像方案与三维（3D）T2 加权成像方案在直肠癌患者术前磁共振（MR）成像中的局部区域分期准确性。
本回顾性研究获得了机构审查委员会的批准，并获得了知情同意豁免。对 109 例直肠癌患者的术前 3TMR 图像进行了 2D 和 3D T2 加权成像方案的回顾性研究。两位放射科医生独立评估了 T 和 N 类病变的影像学表现、肿瘤边界的显影程度以及 2D 和 3D 数据的图像质量。对 3D 数据进行了交互式多平面重建分析。计算并比较了 T2 加权成像分期结果（2D 和 3D 数据）与组织病理学分期结果的线性加权 kappa 值。采用 Wilcoxon 符号秩检验比较肿瘤显影程度和总体图像质量。
2D 和 3D 数据的 T 类病变分期准确性值分别为 66.0%和 67.0%（观察者 1，P=.465）和 63.3%和 56.9%（观察者 2，P=.402）。2D 和 3D T2 加权图像的 N 类病变分期准确性值分别为 64.2%和 57.8%（观察者 1，P=.427）和 47.7%和 62.4%（观察者 2，P=.666）。2D T2 加权成像的肿瘤显影程度更好，但图像质量无显著差异。
常规 2D 和多平面重建 3D T2 加权成像方案在直肠癌患者术前 MR 成像中的分期中，在 T 和 N 类分期的准确性和总体图像质量方面没有显著差异，这取决于伪影程度。然而，3D T2 加权成像方案在病变显影程度方面存在局限性。
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