空气灌肠MR结肠成像检测结、直肠息肉及癌

Detection of colorectal polyps and cancers with air enema MR colonography

目的评价空气灌肠三维Fourier变换快速扰相梯度回波（FSPGR）序列MR结肠成像检测结直肠息肉及癌的灵敏度。方法对30例因便血、大便隐血试验阳性或大便习惯改变而拟接受光学结肠镜检查者进行空气灌肠三维Fourier变换FSPGR序列MR结肠成像及光学结肠镜检查。以光学结肠镜及组织病理学检查为标准,按息肉及癌的大小统计分析MR结肠成像检测结直肠息肉及癌的灵敏度。结果光学结肠镜共检出76枚结直肠息肉及癌,其中1-5 mm息肉11枚、6-9 mm息肉29枚、≥10 mm息肉及癌36枚。MR结肠成像对1-5 mm息肉、6-9 mm息肉、≥10 mm息肉及癌、≥6 mm息肉及癌的检测灵敏度分别为9.09%、75.86%、100%及89.23%,总体检测灵敏度为77.63%。结论空气灌肠三维Fourier变换FSPGR序列MR结肠成像对1-5 mm结直肠息肉检测灵敏度低,但对≥6 mm息肉及癌的检测灵敏度较高,并能够检出全部≥10 mm的息肉及癌。

Objective To evaluate the sensitivity of air enema three-dimensional Fourier transform fast spoiled gradient-recalled（FSPGR） MR colonography in the detection of colorectal polyps and cancers.Methods Thirty patients scheduled for optical colonoscopy due to rectal bleeding,positive fecal occult blood test results or altered bowel habits underwent air enema three-dimensional Fourier transform FSPGR MR colonography and optical colonoscopy.Taking optical colonoscopy and histopathological examinations as standards,the sensitivities of air enema three-dimensional Fourier transform fast spoiled gradient-recalled（FSPGR） MR colonography in the detection of colorectal polyps and cancers were statistically analyzed according to the size of lesions.Results Seventy-six colorectal polyps and cancers were detected with optical colonoscopy,including 1-5 mm polyps（n=11）,6-9 mm polyps（n=29） and ≥10 mm polyps and cancers（n=36） in diameter.The detection sensitivity of 1-5 mm polyps,6-9 mm polyps,≥10 mm polyps and cancers,≥6 mm polyps and cancers with MR colonography was 9.09%,75.86%,100% and 89.23%,respectively,and the overall detection sensitivity of all sizes colorectal polyps and cancers was 77.63%.Conclusion Detection sensitivity of air enema three-dimensional Fourier transform FSPGR MR colonography is low for 1-5 mm colorectal polyps,good for ≥6 mm polyps and cancers,and excellent for all polyps and cancers ≥10 mm.