MRI评估直肠癌新辅助治疗后转归的应用与研究现状

The application and research of MRI in the evaluation of treatment response to neoadjuvant chemoradiotherapy in rectal cancer

新辅助放化疗(NCRT)后行全直肠系膜切除术逐渐成为局部进展期中低位直肠癌病人的标准治疗方法。NCRT治疗后,有些病人甚至可达到完全病理缓解,其局部复发率更低,保肛率及生存率较高。因此,NCRT前对肿瘤转归的可靠预测以及治疗后的准确评估,对于制定多学科、个性化治疗方案十分重要。就MRI评价直肠癌术前环周切缘是否受累、肿瘤体积改变等形态学参数,以及动态增强MRI、扩散加权成像等功能成像参数的应用价值予以综述。

Neoadjuvant chemoradiotherapy （NCRT） following with total mesorectal excision has become the standard of care for the local advanced cancer at low or middle rectum. Some patients can even achieve a pathological complete re-sponse after NCRT, associating with an improved local control and survival rate, and increased probability of anus reserva-tion. Therefore it＇s important to precisely predict the probable response degree of tumor, and to evaluate the regression state after NCRT for making the best multidisciplinary and personalized therapeutic regime in clinical. In this paper, we reviewed the clinical values of MRI morphological parameters, including the situation of preoperative circumferential resection margin and the change of the tumor volume, and the functional parameters, including the dynamic contrast enhanced MRI and diffu-sion weighted imaging parameters.