Masi A, Olmastroni M, Lascialfari L, Messerini L, Fucini C, Cataliotti L, Ficari F, Tonelli F
Unità Operativa di Radiodiagnostica, Presidio Ospedaliero Santa Maria Nuova, Azienda USL n. 10, Università degli Studi, Policlinico Careggi, Firenze.
Radiol Med. 1995 Oct;90(4):431-7.
The accurate locoregional staging of rectal cancer is important in choosing and planning therapy. The diagnostic contribution of endorectal ultrasonography and of Computed Tomography is well known because both methods have been widely used in the last ten years. More recently, Magnetic Resonance Imaging (MRI) has been introduced in the preoperative staging of rectal cancer: most interestingly, in the last three years endorectal surface coils have become available as a clinical device. February through November, 1994, twenty patients affected with rectal carcinoma were examined with endorectal MRI. In order to assess their accuracy, MR staging results were compared with pathologic findings. MRI was performed with an 0.5 T system equipped with an endorectal surface coil. In all cases T2-weighted turbo spin-echo sequences were performed on axial and sagittal or coronal planes. Rectal wall layers were reliably demonstrated in all patients. The comparison with pathologic findings showed 78.9% MR accuracy in assessing tumor infiltration depth. In addition, the study of perirectal lymph nodes showed 83.2% MR sensitivity and 53.8% MR specificity. The high resolution images obtained using endorectal surface coils and the well-known panoramic capabilities of this method reveal MR potentials in rectal carcinoma staging.
直肠癌准确的局部区域分期对于选择和规划治疗方案至关重要。直肠内超声检查和计算机断层扫描的诊断作用已广为人知,因为这两种方法在过去十年中都得到了广泛应用。最近,磁共振成像(MRI)已被引入直肠癌的术前分期:最值得注意的是,在过去三年中,直肠内表面线圈已作为一种临床设备可供使用。1994年2月至11月,对20例直肠癌患者进行了直肠内MRI检查。为了评估其准确性,将MR分期结果与病理结果进行了比较。MRI使用配备直肠内表面线圈的0.5T系统进行。所有病例均在轴位和矢状位或冠状位上进行T2加权快速自旋回波序列扫描。所有患者的直肠壁层均能清晰显示。与病理结果的比较显示,MR在评估肿瘤浸润深度方面的准确率为78.9%。此外,对直肠周围淋巴结的研究显示,MR的敏感性为83.2%,特异性为53.8%。使用直肠内表面线圈获得的高分辨率图像以及该方法众所周知的全景功能揭示了MR在直肠癌分期中的潜力。