直肠癌MRI：放射科医生在日常临床实践中应考虑的方案、征象及未来展望
Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice.
作者信息
Delli Pizzi Andrea, Basilico Raffaella, Cianci Roberta, Seccia Barbara, Timpani Mauro, Tavoletta Alessandra, Caposiena Daniele, Faricelli Barbara, Gabrielli Daniela, Caulo Massimo
机构信息
ITAB Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Via Luigi Polacchi, 11 66100, Chieti, Italy.
SS Annunziata Hospital, Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", 66100, Chieti, Italy.
出版信息
Insights Imaging. 2018 Aug;9(4):405-412. doi: 10.1007/s13244-018-0606-5. Epub 2018 Apr 19.
Abstract
UNLABELLED
Magnetic resonance imaging (MRI) allows to non-invasively evaluate rectal cancer staging and to assess the presence of "prognostic signs" such as the distance from the anorectal junction, the mesorectal fascia infiltration and the extramural vascular invasion. Moreover, MRI plays a crucial role in the assessment of treatment response after chemo-radiation therapy, especially considering the growing interest in the new conservative policy (wait and see, minimally invasive surgery). We present a practical overview regarding the state of the art of the MRI protocol, the main signs that radiologists should consider for their reports during their clinical activity and future perspectives.
TEACHING POINTS
• MRI protocol for rectal cancer staging and re-staging. • MRI findings that radiologists should consider for reports during everyday clinical activity. • Perspectives regarding the development of latest technologies.
摘要
未标注
磁共振成像（MRI）能够非侵入性地评估直肠癌分期，并评估“预后征象”的存在情况，如距肛管直肠交界的距离、直肠系膜筋膜浸润及壁外血管侵犯。此外，MRI在评估放化疗后的治疗反应中起着关键作用，尤其是考虑到对新的保守策略（观察等待、微创手术）的兴趣日益增加。我们提供了一份关于MRI检查方案的现状、放射科医生在临床工作中撰写报告时应考虑的主要征象以及未来前景的实用概述。
教学要点
• 直肠癌分期及再分期的MRI检查方案。• 放射科医生在日常临床工作中撰写报告时应考虑的MRI表现。• 最新技术发展的前景。
相似文献
1
Rectal cancer MRI: protocols, signs and future perspectives radiologists should consider in everyday clinical practice.直肠癌MRI：放射科医生在日常临床实践中应考虑的方案、征象及未来展望
Insights Imaging. 2018 Aug;9(4):405-412. doi: 10.1007/s13244-018-0606-5. Epub 2018 Apr 19.
2
MRI for Rectal Cancer Primary Staging and Restaging After Neoadjuvant Chemoradiation Therapy: How to Do It During Daily Clinical Practice.MRI 用于直肠癌新辅助放化疗后的原发灶和复发病灶分期：如何在日常临床实践中进行。
Eur J Radiol. 2020 Oct;131:109238. doi: 10.1016/j.ejrad.2020.109238. Epub 2020 Aug 29.
3
Selection of Patients With Rectal Cancer for Preoperative Chemoradiotherapy: Are T Category and Nodal Status All That Matters?直肠癌患者术前放化疗的选择：T 分期和淋巴结状态是否至关重要？
Dis Colon Rectum. 2019 Apr;62(4):447-453. doi: 10.1097/DCR.0000000000001229.
4
The prognostic importance of MRI detected extramural vascular invasion (mrEMVI) in locally advanced rectal cancer.MRI 检测到的局部晚期直肠癌外突血管侵犯（mrEMVI）的预后意义。
Int J Colorectal Dis. 2020 Oct;35(10):1849-1854. doi: 10.1007/s00384-020-03632-9. Epub 2020 Jun 2.
5
Role of dynamic perfusion magnetic resonance imaging in patients with local advanced rectal cancer.动态灌注磁共振成像在局部进展期直肠癌患者中的作用。
World J Gastroenterol. 2020 May 28;26(20):2657-2668. doi: 10.3748/wjg.v26.i20.2657.
6
Can CT replace MRI in preoperative assessment of the circumferential resection margin in rectal cancer?CT 能否替代 MRI 用于直肠癌术前评估环周切缘？
Dis Colon Rectum. 2010 Mar;53(3):308-14. doi: 10.1007/DCR.0b013e3181c5321e.
7
Pathologic Complete Response in Rectal Cancer: Can We Detect It? Lessons Learned From a Proposed Randomized Trial of Watch-and-Wait Treatment of Rectal Cancer.直肠癌的病理完全缓解：我们能检测到吗？从一项拟议的直肠癌观察等待治疗随机试验中吸取的教训。
Dis Colon Rectum. 2016 Apr;59(4):255-63. doi: 10.1097/DCR.0000000000000558.
8
Improved detection of a tumorous involvement of the mesorectal fascia and locoregional lymph nodes in locally advanced rectal cancer using DCE-MRI.使用动态对比增强磁共振成像（DCE-MRI）改善局部晚期直肠癌中直肠系膜筋膜和局部区域淋巴结肿瘤累及情况的检测。
Int J Colorectal Dis. 2018 Jul;33(7):901-909. doi: 10.1007/s00384-018-3083-x. Epub 2018 May 17.
9
Preoperative concurrent chemoradiotherapy MRI characteristics favouring pathologic complete response in patients with rectal cancer: Usefulness of MR T2-stage as an ancillary finding for predicting pathologic complete response.术前同步放化疗 MRI 特征有利于直肠癌患者的病理完全缓解：MR T2 分期作为预测病理完全缓解的辅助发现的有用性。
J Med Imaging Radiat Oncol. 2021 Apr;65(2):166-174. doi: 10.1111/1754-9485.13132. Epub 2020 Dec 14.
10
Imaging and Management of Rectal Cancer.直肠癌的影像学诊断与处理。
Semin Ultrasound CT MR. 2020 Apr;41(2):183-206. doi: 10.1053/j.sult.2020.01.001. Epub 2020 Jan 24.
引用本文的文献
1
Accelerated T2W Imaging with Deep Learning Reconstruction in Staging Rectal Cancer: A Preliminary Study.深度学习重建在直肠癌分期中的加速T2加权成像：一项初步研究。
J Imaging Inform Med. 2025 Aug;38(4):2537-2548. doi: 10.1007/s10278-024-01345-x. Epub 2024 Dec 11.
2
MRI for Rectal Cancer: Updates and Controversies- Expert Panel Narrative Review.直肠癌的磁共振成像：最新进展与争议——专家小组叙述性综述
AJR Am J Roentgenol. 2025 Jun;224(6):e2431523. doi: 10.2214/AJR.24.31523. Epub 2024 Sep 25.
3
Multi-omics staging of locally advanced rectal cancer predicts treatment response: a pilot study.多组学局部晚期直肠癌分期预测治疗反应：一项初步研究。
Radiol Med. 2024 May;129(5):712-726. doi: 10.1007/s11547-024-01811-0. Epub 2024 Mar 27.
4
Progress of Multiparameter Magnetic Resonance Imaging in Bladder Cancer: A Comprehensive Literature Review.多参数磁共振成像在膀胱癌中的研究进展：一项全面的文献综述
Diagnostics (Basel). 2024 Feb 17;14(4):442. doi: 10.3390/diagnostics14040442.
5
The incidence of malignancy in the residual rectum of IBD patients after colectomy: a systematic review and meta-analysis.炎症性肠病患者结肠切除术后残留直肠恶性肿瘤的发病率：系统评价和荟萃分析。
Tech Coloproctol. 2023 Sep;27(9):699-712. doi: 10.1007/s10151-023-02762-w. Epub 2023 Mar 12.
6
Application of Radiomics in Predicting Treatment Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: Strategies and Challenges.放射组学在预测局部晚期直肠癌新辅助放化疗治疗反应中的应用：策略与挑战
J Oncol. 2022 Nov 26;2022:1590620. doi: 10.1155/2022/1590620. eCollection 2022.
7
Apparent diffusion coefficient histogram analysis for predicting neoadjuvant chemoradiotherapy response in patients with rectal cancer.表观扩散系数直方图分析预测直肠癌新辅助放化疗反应。
Diagn Interv Radiol. 2022 Sep;28(5):403-409. doi: 10.5152/dir.2022.201112.
8
MRI interobserver reliability in rectal tumor angulation.直肠肿瘤角度测量中MRI观察者间的可靠性
Acta Radiol Open. 2022 Feb 23;11(2):20584601221081292. doi: 10.1177/20584601221081292. eCollection 2022 Feb.
9
Comparison of the diagnostic accuracy and validity of biparametric MRI and multiparametric MRI-based VI-RADS scoring in bladder cancer; is contrast material really necessary in detecting muscle invasion?基于 biparametric MRI 和 multiparametric MRI-based VI-RADS 评分的膀胱癌诊断准确性和有效性比较；在检测肌肉侵犯时，造影剂真的有必要吗？
Abdom Radiol (NY). 2022 Feb;47(2):771-780. doi: 10.1007/s00261-021-03383-3. Epub 2021 Dec 17.
10
Radiomics and machine learning applications in rectal cancer: Current update and future perspectives.直肠癌的放射组学和机器学习应用：现状更新与未来展望。
World J Gastroenterol. 2021 Aug 28;27(32):5306-5321. doi: 10.3748/wjg.v27.i32.5306.
本文引用的文献
1
MR imaging perfusion and diffusion analysis to assess preoperative Short Course Radiotherapy response in locally advanced rectal cancer: Standardized Index of Shape by DCE-MRI and intravoxel incoherent motion-derived parameters by DW-MRI.磁共振灌注和弥散分析评估局部进展期直肠癌术前短程放疗反应：DCE-MRI 的标准化形状指数和 DW-MRI 的体素内不相干运动衍生参数。
Med Oncol. 2017 Nov 18;34(12):198. doi: 10.1007/s12032-017-1059-2.
2
Magnetic resonance imaging for clinical management of rectal cancer: Updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting.磁共振成像在直肠癌临床管理中的应用：2016 年欧洲胃肠道和腹部放射学会（ESGAR）共识会议的更新建议。
Eur Radiol. 2018 Apr;28(4):1465-1475. doi: 10.1007/s00330-017-5026-2. Epub 2017 Oct 17.
3
A Distal Resection Margin of ≤1 mm and Rectal Cancer Recurrence After Sphincter-Preserving Surgery: The Role of a Positive Distal Margin in Rectal Cancer Surgery.保肛手术后远端切缘≤1毫米与直肠癌复发：远端切缘阳性在直肠癌手术中的作用
Dis Colon Rectum. 2017 Nov;60(11):1175-1183. doi: 10.1097/DCR.0000000000000900.
4
Magnetic Resonance Imaging Evaluation in Neoadjuvant Therapy of Locally Advanced Rectal Cancer: A Systematic Review.磁共振成像在局部晚期直肠癌新辅助治疗中的评估：一项系统综述
Radiol Oncol. 2017 Aug 16;51(3):252-262. doi: 10.1515/raon-2017-0032. eCollection 2017 Sep.
5
Deep Learning for Fully-Automated Localization and Segmentation of Rectal Cancer on Multiparametric MR.深度学习在多参数磁共振直肠癌全自动定位和分割中的应用
Sci Rep. 2017 Jul 13;7(1):5301. doi: 10.1038/s41598-017-05728-9.
6
Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching.磁共振弥散加权成像评估直肠癌放化疗反应：主要解读误区及其在教学中的应用。
Eur Radiol. 2017 Oct;27(10):4445-4454. doi: 10.1007/s00330-017-4830-z. Epub 2017 Apr 13.
7
Sequential PET/CT with [18F]-FDG Predicts Pathological Tumor Response to Preoperative Short Course Radiotherapy with Delayed Surgery in Patients with Locally Advanced Rectal Cancer Using Logistic Regression Analysis.采用逻辑回归分析，[18F]-氟代脱氧葡萄糖序贯PET/CT可预测局部晚期直肠癌患者术前短程放疗加延迟手术的病理肿瘤反应。
PLoS One. 2017 Jan 6;12(1):e0169462. doi: 10.1371/journal.pone.0169462. eCollection 2017.
8
Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile.标准化形状指数（动态对比增强磁共振成像）和标准化摄取值（正电子发射断层显像/X线计算机体层成像）：两种基于功能特征鉴别局部晚期直肠癌放化疗反应者的定量方法。
Oncotarget. 2017 Jan 31;8(5):8143-8153. doi: 10.18632/oncotarget.14106.
9
DWI for Assessment of Rectal Cancer Nodes After Chemoradiotherapy: Is the Absence of Nodes at DWI Proof of a Negative Nodal Status?磁共振扩散加权成像用于评估直肠癌放化疗后淋巴结情况：磁共振扩散加权成像未见淋巴结能否证明淋巴结状态为阴性？
AJR Am J Roentgenol. 2017 Mar;208(3):W79-W84. doi: 10.2214/AJR.16.17117. Epub 2016 Dec 13.
10
Nodal staging in rectal cancer: why is restaging after chemoradiation more accurate than primary nodal staging?直肠癌的淋巴结分期：为何放化疗后的再分期比初次淋巴结分期更准确？
Int J Colorectal Dis. 2016 Jun;31(6):1157-62. doi: 10.1007/s00384-016-2576-8. Epub 2016 Apr 7.
Zotero 插件