MRI及DCE-MRI在直肠癌术前诊断及分期中的应用价值

Application Value of MRI and DCE-MRI on Preoperative Diagnosis and Staging of Rectal Cancer

目的探讨MRI及DCE-MRI在直肠癌术前诊断及分期中的应用价值。方法选择经肠镜活检确诊为直肠癌的患者32例,按照随机样本表法将患者分为2组,行MRI检查16例,行DCE-MRI检查16例,同时选择健康志愿者10名行常规盆腔DCE-MRI扫描作为对照。对比MRI及DCE-MRI T分期和N分期诊断差异,直肠癌病灶和直肠正常肠壁的TIC参数差异。结果 MRI评价T分期有3例过高分期,2例过低分期,DCE-MRI有3例过高分期,1例过低分期,DCE-MRI对于T1-2、T3分期准确率高于MRI;MRI评价N分期有1例过高分期,4例过低分期,DCE-MRI有2例过高分期,2例过低分期,DCE-MRI对于N0、N1、N2分期准确率高于MRI(P>0.05)。直肠癌病灶的SImin、SImax、SIR均高于直肠正常肠壁,而Tpeak小于直肠正常肠壁(P<0.05)。结论 MRI及DCE-MRI对直肠癌进行术前分期评价具有准确、系统、科学的特点,而DCE-MRI还能反映病灶局部的血液循环情况。

Objective To investigate application value of MRI and DCE-MRI on preoperative diagnosis and staging of rectal cancer. Methods 32 eases of rectal cancer patients diagnosed by colonoscopy biopsy were selected. According to random table method,patients were divided into 2 groups, 16 eases received MRI, 16 eases received DCE-MRI. 10 healthy volunteers re- ceived DCE-MRI were selected as the control group. The diagnosis of T and N stage by MRI and DCE-MRI were compared, TIC parameters of rectal cancer lesions and normal intestinal wall were compared. Results MRI evaluation of T staging had 3 cases of over instalhnents,2 below installments. DCE-MRI evaluation had 3 cases of over installments, 1 below installments, accuracy of DCE-MRI on T1-2 ,T3 were higher than that of MRI;MRI evaluation on N staging had 1 cases of over installments,4 below installments. DCE-MRI evaluation had 2 cases of over installments ,2 below installments, accuracy of DCE-MRI on N0 ,N1 ,N2 were higher than that of MRI （P 〉 0.05） ;Slmin,SImax,SIR of rectal cancer lesions were higher than that of normal intestinal wall, while Tpeak of rectal cancer lesions was higher than that of normal intestinal wall（ P 〈 0.05 ）. Conclusion MRI and DCE-MRI on preoperative diagnosis and staging of rectal cancer are accurate, systematic and scientific, and DCE-MRI can also reflect local blood circulation.