Pierredon-Foulongne M-A, Nougaret S, Bibeau F, Rouanet P, Delhom E, Lonjon J, Ragu N, Colleau J, Schembri V, Guiu B, Gallix B
Department of Medical Imaging, Saint-Eloi Hospital, Montpellier University Hospitals, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
Department of Medical Imaging, Saint-Eloi Hospital, Montpellier University Hospitals, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
Diagn Interv Imaging. 2014 May;95(5):495-503. doi: 10.1016/j.diii.2014.03.010. Epub 2014 Apr 22.
We describe the main tools for MR assessment of the response of rectal cancer tumors after chemotherapy, before surgery. In locally advanced cases of rectal and lower rectal cancer, MR is useful in allowing the treatment strategy to be adjusted, enabling conservative surgery to be performed if the patient responds well. The different types of response (fibrous, desmoplastic and colloid), their appearances and difficulties in MR interpretation are described. We describe the features and performance of MR after neoadjuvant therapy for T and N staging, assessment of circumferential resection margin and diffusion weighted imaging. Quantitative (change in tumor volume) and qualitative (grade of tumor response) MR assessment can distinguish good responders from poor responders.
我们描述了在术前对直肠癌肿瘤化疗反应进行磁共振（MR）评估的主要工具。在局部晚期直肠癌和低位直肠癌病例中，MR有助于调整治疗策略，若患者反应良好则可进行保肛手术。文中描述了不同类型的反应（纤维型、促结缔组织增生型和黏液型）、它们的表现以及MR解读中的难点。我们还描述了新辅助治疗后MR在T和N分期、环周切缘评估及扩散加权成像方面的特征和表现。MR的定量评估（肿瘤体积变化）和定性评估（肿瘤反应分级）能够区分反应良好者和反应不佳者。
