Guinet C, Ghossain M, Buy J N, Sézeur A, Mallet A, Bigot J M, Malbec L, Vadrot D, Ecoiffier J
Service de Radiologie, Hôtel-Dieu de Paris.
J Radiol. 1990 May;71(5):357-63.
Twenty-one patients with middle and low rectal carcinomas have been operated by abdominoperineal resection (APR) in 11 patients, and low anterior resection (LAR) with coloanal anastomosis in 7 and colorectal anastomosis in 3. The distance of the lower margin of the tumor to insertion of the levator ani on the rectal wall was correctly evaluated by CT in 15 of 21 cases (71%) and by MR in 14 of 21 (67%) while digital examination correctly assessed the distance in 17 of 21 (81%). CT and MR were unable to assess extension through the rectal wall. No significant discordance was observed between CT and MR in assessing extension to the perivesical fat, adjacent organs, pelvic side wall or lymphnodes. According to the TNM classification, MR correctly staged 76% (16 of 21) of patients while CT correctly staged 71% (15 of 21).
21例中低位直肠癌患者接受了手术治疗，其中11例行腹会阴联合切除术（APR），7例行低位前切除术（LAR）并结肠肛管吻合，3例行结直肠吻合。CT在21例中的15例（71%）、MR在21例中的14例（67%）正确评估了肿瘤下缘至直肠壁肛提肌附着处的距离，而指诊在21例中的17例（81%）正确评估了该距离。CT和MR均无法评估肿瘤穿透直肠壁的情况。在评估肿瘤向膀胱周围脂肪、相邻器官、盆腔侧壁或淋巴结的侵犯方面，CT和MR之间未观察到显著差异。根据TNM分类，MR正确分期的患者为76%（21例中的16例），CT正确分期的患者为71%（21例中的15例）。
