MRI动态增强在直肠癌诊断中的价值

Evaluation of magnetic resonance imaging dynamic enhancing in rectal cancer

目的:探讨直肠癌磁共振动态增强检查的影像表现及应用价值。方法:2005年12月-2010年3月96例直肠癌患者于术前行动态增强扫描,其中73例直肠癌患者,绘制时间-信号强度曲线,测量直肠肿瘤、正常直肠肠壁、盆腔淋巴结的峰值时间、峰值、信号强化率、最大信号强化率。比较不同临床病理分期与磁共振动态增强参数值之间的关系。结果:磁共振动态增强检查中,直肠癌相较于正常直肠肠壁具有更早的峰值时间[T peak(18.9±6.7)vs(21.4±6.6),P=0.046 8]及更高的峰值[SI peak(1 105.9±354.6)vs(805.2±345.8),P<0.000 1]、信号强化率[E(191.6±65.4)vs(158.0±67.3),P=0.028 7]。Dukes分期C的直肠癌具有更早的T peak值和更高的Kep(P=0.045 3)。结论:直肠癌的磁共振功能成像可以部分反映肿瘤局部血管情况,为临床治疗与术后评估提供帮助。

Objective： To study the application value of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） in rectal carcinoma. Methods： 96 patients with rectal cancer proven pathologically were underwent dynamic contrast enhancement sequences before surgery. Time-intensity curves（TICs） were used to measure time to peak enhancement（Trek）, SI, signal enhancement ratio（E）, and Emax for rectal tumor, normal rectal wall, and lymph node in pelvic cavity in 73 of 96 patients. Results： Rectal carcinoma showed higher Sit, k[（1 105.9±354.6） vs （805.2±345.8）, P〈0.000 1], E[（191.6±65.4） vs （158.0±67.3）, P=0.028 7] and earlier Tpeak[（18.9±6.7） vs （21.4±6.6）, P=0.046 8] than those in normal rectal wall. Conclusion： DCE-MRI parameters can be helpful to predict rectal tumor angiogenesis and to discriminate malignant from normal tissue.