3.0T磁共振多序列成像评估食管鳞状细胞癌侵犯胸主动脉

Assessment of the invasion of esophageal squamous cell carcinoma to thoracic aorta with 3.0T multiple magnetic resonance imaging sequences

目的:探讨术前3.0T磁共振多序列成像评估食管鳞状细胞癌侵犯胸主动脉的价值。方法 :收集我院经食管X线钡剂检查、食管镜检证实为食管鳞状细胞癌患者49例,均在术前3天内行3.0T磁共振多序列成像扫描。根据MRI资料,参照接触角法、三角法标准判断食管肿瘤侵犯胸主动脉的情况,将影像分析结果与术中所见及术后病理学结果进行对照研究。结果:术前3.0T磁共振多序列成像判断食管鳞状细胞癌侵犯胸主动脉,以Hiari等和Furukawa等报道的接触角法为参考标准,其灵敏度、特异度、准确度分别为84.78%、66.67%、83.67%;以Takashima等提出的三角法为参照标准,其敏感度、特异度和准确度分别为95.65%、100%、95.92%。结论:3.0T磁共振多序列成像能清晰显示食管癌与胸主动脉的关系,对判断食管癌是否侵犯胸主动脉及其手术可切除性具有重要临床价值。

Objective： To explore the value of preoperative 3.0T MRI using multiple sequences in evaluating the esophageal squamous cell carcinoma invading thoracic aorta. Methods： Forty-nine patients with esophageal squamous cell car- cinoma confirmed by esophageal X-ray barium and esophagoscope biopsy underwent preoperative muhiple sequence MRI scan three days before surgical treatment. According to the MRI data, the esophageal tumor invading thoracic aorta was determined by the combination of the contact angle method and triangle method as the reference standards. The imaging findings were compared with intraoperative observations and postoperative pathologic results. Results： According to ＂contact angle method＂ reported by Hiari et al and Furukawa et al as the reference standard, the sensitivity, specificity and accuracy of MRI deter- mining the invasion of esophageal squamous cell carcinoma to thoracic aorta were 84.78%, 66.67% and 83.67%, respectively. According to the ＂triangle method＂ reported by Takashima et al as the reference standard, the sensitivity, specificity and ac- curacy of this method were 95.65%, 100% and 95.92%, respectively. Conclusion： 3.0T multiple sequence MRI can clearly show the anatomical relationship between esophageal cancer and thoracic aorta, and can be of great clinical application value to determine the invasion of esophageal carcinoma into thoracic aorta and its resectability.