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[放射学在结直肠癌初始分期中的作用]

[Role of radiology for primary staging of colorectal cancer].

作者信息

Wirth Sophia, Bogveradze Nino, Lampichler Katharina

机构信息

Universitätsklinik für Allgemeine Radiologie und Kinderradiologie, Währinger Gürtel 18-20, 1090, Wien, Österreich.

American Hospital Tbilisi, Tiflis, Georgien.

出版信息

Radiologie (Heidelb). 2025 May 19. doi: 10.1007/s00117-025-01458-6.

Abstract

BACKGROUND

Imaging, specifically magnetic resonance imaging (MRI), has long been the cornerstone for staging rectal cancer. In contrast, computed tomography (CT) is the standard for colon cancer staging. Primary staging is essential for individualized risk stratification and therapy planning.

OBJECTIVES

To summarize current international guidelines on primary colorectal cancer staging, taking into account the advantages and disadvantages of different imaging methods.

MATERIALS AND METHODS

Based on extensive literature research, the current state of knowledge in the staging of colorectal cancer is summarized.

RESULTS

TNM staging includes local tumor extension as well as the presence of lymph node and distant metastases. For local tumor extension, MRI is very well suited for rectal cancer. In colon cancer, CT shows significant limitations regarding the sensitivity of differentiating individual stages. Lymph node metastases can pose a major challenge for both MRI and CT, which has led to the definition of several malignancy criteria. The detection of distant metastases remains primarily within the domain of CT, except for liver metastases.

CONCLUSIONS

Depending on tumor location, either MRI or CT is recommended for primary staging of colorectal cancer, and a combination of both modalities may also be appropriate. Accurate assessment of the primary tumor, lymph nodes, and organs using imaging is an essential component of the therapeutic approach to colorectal cancer.

摘要

背景

影像学检查,尤其是磁共振成像(MRI),长期以来一直是直肠癌分期的基石。相比之下,计算机断层扫描(CT)是结肠癌分期的标准。初始分期对于个体化风险分层和治疗规划至关重要。

目的

考虑不同成像方法的优缺点,总结当前关于原发性结直肠癌分期的国际指南。

材料与方法

基于广泛的文献研究,总结结直肠癌分期的当前知识状态。

结果

TNM分期包括局部肿瘤扩展以及淋巴结和远处转移的情况。对于局部肿瘤扩展,MRI非常适合直肠癌。在结肠癌中,CT在区分各个分期的敏感性方面存在显著局限性。淋巴结转移对MRI和CT来说都是一项重大挑战,这导致了几种恶性标准的定义。除肝转移外,远处转移的检测主要依靠CT。

结论

根据肿瘤位置,推荐使用MRI或CT进行结直肠癌的初始分期,两种方法联合使用也可能是合适的。利用影像学准确评估原发肿瘤、淋巴结和器官是结直肠癌治疗方法的重要组成部分。

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