滑动多层磁共振成像在直肠间质瘤分期中的应用价值

Application of Sliding Multislice MRI in Staging of Rectal Gastrointestinal Stromal Tumors

目的探讨滑动多层(sliding multislice,SMS)磁共振成像(MRI)在胃肠道间质瘤(gastrointestinal stromal tumours,GIST)腹部分期中的应用价值和潜力。方法2005年9月至2008年1月8例由组织学和免疫组化检测证实的直肠GIST患者,均接受盆腔静止高分辨率MRI和腹部SMS MRI检查进行治疗前分期。在盆腔静止高分辨率MRI采用T2-TSE序列检查后,利用SMS技术的T1加权增强FLASH-2D序列在1 min内检查整个腹部。分析图像,分别了解直肠GIST原发部位情况及腹部远处转移情况。结果盆腔静止高分辨率MRI检查成功确定所有患者直肠GIST的大小、范围及局部侵犯程度,肿瘤最大直径介于1.7～11.0 cm。SMS MRI检查的图像质量能够满足对可能的肝转移灶、转移淋巴结、肠系膜转移灶和骨转移灶的评价。结论腹部SMS MRI联合盆腔静止高分辨率MRI可以在一次检查中完成直肠GIST的腹部分期。

Objective To investigate the value and potential of sliding multislice（SMS） MRI in staging of rectal gastrointestinal stromal tumors（GIST）. Methods During the period of September 2005 ancl January 2008,8 patients with rectal GIST confirmed histologically ancl immunohistochemically received high resolution pelvic MRI and abdominal SMS MRI for pre-treatment staging of rectal GIST. An axial T1-weighted contrast-enhanced FLASH 2D sequence was acquired after a high resolution pelvic MRI within one min from the diaphragm to the pelvic floor during continuous table movement with the SMS acquisition technique. Local staging and abdominal staging of rectal GIST were evaluated by analyzing MRI images. Results In all patients, the exact extent of rectal GIST and infiltration of local organs could be successfully determined with the largest tumor diameters ranging from 1.7-11. 0 cm. In all the cases, the SMS MRI rendered excellent image quality for assessment of possible liver,lymph node, mesenteric and bone metastases. No malignant abdominal metastases were encountered in any of the patients. Conclusion Combining SMS MRI with high resolution pelvic MRI could achieve abdominal staging of rectal GIST within one MRI imaging protocol.