Zagoria R J, Schlarb C A, Ott D J, Bechtold R I, Wolfman N T, Scharling E S, Chen M Y, Loggie B W
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University Winston-Salem, North Carolina.
J Surg Oncol. 1997 Apr;64(4):312-7. doi: 10.1002/(sici)1096-9098(199704)64:4<312::aid-jso12>3.0.co;2-4.
The preoperative assessment of depth of invasion of rectal carcinoma is increasingly important as new treatment methodologies are developed. Accuracy of preoperative endorectal MR imaging was therefore compared with that of the endoscopic rectal sonography in determining depth of invasion of rectal carcinomas.
From March 1993 to April 1994, 10 consecutive patients with biopsy-proven rectal carcinomas were imaged with both endorectal MR imaging and endoscopic rectal sonography. These two studies were performed an average of 2.7 days apart in each patient. All 10 patients had surgical resection of the rectal carcinoma within days of imaging studies. TNM staging of each malignant lesion was correlated with the imaging reports.
Staging accuracy was 80% for endorectal MR imaging and 70% for endoscopic rectal sonography. With MR imaging, one T2 lesion was overstaged and one T3 lesion was understaged. With sonography, two T2 lesions were overstaged and one T3 lesion was understaged. One MR error resulted from misinterpretation. All other staging errors occurred in patients with tumor spread into, but not through, the muscularis propria or with microscopic spread through this layer.
Endorectal MR imaging and endoscopic rectal sonography have similar accuracy for assessing depth of invasion of rectal carcinoma.
随着新治疗方法的发展，直肠癌浸润深度的术前评估变得越来越重要。因此，比较了术前直肠内磁共振成像（MR成像）与内镜直肠超声检查在确定直肠癌浸润深度方面的准确性。
从1993年3月至1994年4月，对10例经活检证实为直肠癌的连续患者进行了直肠内MR成像和内镜直肠超声检查。这两项检查在每位患者中平均间隔2.7天进行。所有10例患者在成像研究后的数天内均接受了直肠癌手术切除。每个恶性病变的TNM分期与成像报告相关。
直肠内MR成像的分期准确率为80%，内镜直肠超声检查为70%。在MR成像中，1个T2期病变分期过高，1个T3期病变分期过低。在超声检查中，2个T2期病变分期过高，1个T3期病变分期过低。1个MR错误是由于误判导致的。所有其他分期错误均发生在肿瘤扩散至固有肌层但未穿透固有肌层或显微镜下扩散穿过该层的患者中。
直肠内MR成像和内镜直肠超声检查在评估直肠癌浸润深度方面具有相似的准确性。
