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磁共振相控阵技术术前直肠癌分期

Preoperative rectal cancer staging with phased-array MR.

机构信息

Department of Diagnostic Radiology, University of Pisa, Via Roma 67, 56100-Pisa, Italy.

出版信息

Radiat Oncol. 2012 Mar 5;7:29. doi: 10.1186/1748-717X-7-29.

DOI:10.1186/1748-717X-7-29
PMID:22390136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3310712/
Abstract

BACKGROUND

We retrospectively reviewed magnetic resonance (MR) images of 96 patients with diagnosis of rectal cancer to evaluate tumour stage (T stage), involvement of mesorectal fascia (MRF), and nodal metastasis (N stage).Our gold standard was histopathology.

METHODS

All studies were performed with 1.5-T MR system (Symphony; Siemens Medical System, Erlangen, Germany) by using a phased-array coil. Our population was subdivided into two groups: the first one, formed by patients at T1-T2-T3, N0, M0 stage, whose underwent MR before surgery; the second group included patients at Tx N1 M0 and T3-T4 Nx M0 stage, whose underwent preoperative MR before neoadjuvant chemoradiation therapy and again 4-6 wks after the end of the treatment for the re-staging of disease.Our gold standard was histopathology.

RESULTS

MR showed 81% overall agreement with histological findings for T and N stage prediction; for T stage, this rate increased up to 95% for pts of group I (48/96), while for group II (48/96) it decreased to 75%.Preoperative MR prediction of histologically involved MRF resulted very accurate (sensitivity 100%; specificity 100%) also after chemoradiation (sensitivity 100%; specificity 67%).

CONCLUSIONS

Phased-array MRI was able to clearly estimate the entire mesorectal fat and surrounding pelvic structures resulting the ideal technique for local preoperative rectal cancer staging.

摘要

背景

我们回顾性分析了 96 例直肠癌患者的磁共振（MR）图像，以评估肿瘤分期（T 分期）、直肠系膜筋膜（MRF）受累情况和淋巴结转移（N 分期）。我们的金标准是组织病理学。

方法

所有研究均在 1.5-T MR 系统（Symphony；西门子医疗系统，德国埃朗根）上使用相控阵线圈进行。我们的人群分为两组：第一组，由 T1-T2-T3、N0、M0 期的患者组成，这些患者在手术前进行了 MR 检查；第二组包括 TxN1M0 和 T3-T4NxM0 期的患者，这些患者在新辅助放化疗前进行了术前 MR 检查，并在治疗结束后 4-6 周再次进行检查，以重新分期疾病。我们的金标准是组织病理学。

结果

MR 对 T 和 N 分期的预测与组织学发现总体上具有 81%的一致性；对于 T 分期，对于第一组（48/96）的患者，这一比例上升至 95%，而对于第二组（48/96）的患者，这一比例下降至 75%。术前 MR 对组织学上受累的 MRF 的预测非常准确（敏感性 100%；特异性 100%），即使在放化疗后也是如此（敏感性 100%；特异性 67%）。

结论

相控阵 MRI 能够清晰地评估整个直肠系膜脂肪和周围盆腔结构，是局部术前直肠癌分期的理想技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/60942036af76/1748-717X-7-29-10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/1dc117b488f6/1748-717X-7-29-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/29cc745d374d/1748-717X-7-29-2.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/c7fa414ede4f/1748-717X-7-29-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/9bc7e4dd285c/1748-717X-7-29-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/520110698f2f/1748-717X-7-29-8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/fa0ec92b8f67/1748-717X-7-29-9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/60942036af76/1748-717X-7-29-10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/1dc117b488f6/1748-717X-7-29-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/29cc745d374d/1748-717X-7-29-2.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/3b86f707139b/1748-717X-7-29-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/c7fa414ede4f/1748-717X-7-29-6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/9bc7e4dd285c/1748-717X-7-29-7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/520110698f2f/1748-717X-7-29-8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/fa0ec92b8f67/1748-717X-7-29-9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/962e/3310712/60942036af76/1748-717X-7-29-10.jpg

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