核磁共振成像在直肠癌术后复发诊断中的应用价值

The value of MRI for diagnosis of recurrence of rectal carcinoma after surgical resection

目的探讨核磁共振成像（ＭＲＩ）在直肠癌术后复发诊断中的应用价值。方法复习资料完整的直肠癌术后疑复发而行ＭＲＩ检查的病例３４例，应用标准ＳＥ序列，行轴位Ｔ１ＷＩ、Ｔ２ＷＩ及矢状位Ｔ１ＷＩ序列扫描盆腔。２例行静脉ＧｄＤＴＰＡ增强扫描。结果肿瘤复发２７例，主要表现为骶前及会阴区肿物，Ｔ１ＷＩ呈低信号，Ｔ２ＷＩ呈混杂稍高信号，矢状位Ｔ１ＷＩ骶前脂肪间隙不连续或消失。复发肿瘤侵犯膀胱８例，侵犯前列腺６例，明确骶尾骨转移６例，盆腔淋巴结肿大３例。３４例中，７例未见复发。结论ＭＲＩ对发现直肠癌术后复发并确定病变侵犯范围有重要价值。

Objective To define the possible role of magnetic resonance imaging (MRI) for diagnosis of local recurrence of rectal carcinoma. Methods Pelvic MRI scans of 34 patients with rectal carcinoma received surgical resection were reviewed. SE sequence: Axial T 1WI, T 2WI and sagittal T 1WI scanning of pelvis were performed. Two patients had Gd DTPA enhancement. Results Of the 34 patients 27 developed recurrence. The major MRI findings were :tumor mass in the sacro anterior and perineal regions, T 1WI with low signal intensity, T 2WI with mixed but slightly high signal intensity, and discontinuity or loss of sacro anterior fat space on sagittal T 1WI. Cancer invasion could be detected to urinary bladder in 8 patients, to prostate in 6 patients, to sacrum in 6 patiens. Pelvic lymph node enlargement was seen in 3 patients. Seven patients did not show any signs of tumor recurrence. Conclusion Routine follow up MRI scan after rectal carcinoma resection is useful in revealing recurrence of cancer and its extent of involvement.