Tapan Umit, Ozbayrak Mustafa, Tatlı Servet
Department of Hematology/Oncology, Boston University Medical Center, Boston, Massachusetts, USA.
Diagn Interv Radiol. 2014 Sep-Oct;20(5):390-8. doi: 10.5152/dir.2014.13265.
Preoperative imaging for staging of rectal cancer has become an important aspect of current approach to rectal cancer management, because it helps to select suitable patients for neoadjuvant chemoradiotherapy and determine the appropriate surgical technique. Imaging modalities such as endoscopic ultrasonography, computed tomography, and magnetic resonance imaging (MRI) play an important role in assessing the depth of tumor penetration, lymph node involvement, mesorectal fascia and anal sphincter invasion, and presence of distant metastatic diseases. Currently, there is no consensus on a preferred imaging technique for preoperative staging of rectal cancer. However, high-resolution phased-array MRI is recommended as a standard imaging modality for preoperative local staging of rectal cancer, with excellent soft tissue contrast, multiplanar capability, and absence of ionizing radiation. This review will mainly focus on the role of MRI in preoperative local staging of rectal cancer and discuss recent advancements in MRI technique such as diffusion-weighted imaging and dynamic contrast-enhanced MRI.
直肠癌术前分期成像已成为当前直肠癌治疗方法的一个重要方面，因为它有助于选择适合新辅助放化疗的患者，并确定合适的手术技术。诸如内镜超声、计算机断层扫描和磁共振成像（MRI）等成像方式在评估肿瘤浸润深度、淋巴结受累情况、直肠系膜筋膜和肛门括约肌侵犯以及远处转移性疾病的存在方面发挥着重要作用。目前，对于直肠癌术前分期的首选成像技术尚无共识。然而，高分辨率相控阵MRI被推荐作为直肠癌术前局部分期的标准成像方式，它具有出色的软组织对比度、多平面成像能力且无电离辐射。本综述将主要关注MRI在直肠癌术前局部分期中的作用，并讨论MRI技术如扩散加权成像和动态对比增强MRI的最新进展。
