直肠系膜筋膜MRI薄层检查对直肠癌邻近浸润的临床价值分析

Clinical value of MRI thin layer examination of rectal mesenteric fascia for adjacent infiltration of rectal cancer

目的探讨直肠系膜筋膜MRI薄层检查对直肠癌邻近浸润的临床价值。方法选取2014年10月—2018年2月我院收治的直肠癌患者35例,准确测量直肠癌的位置及范围,并观察直肠癌及其周围结构的MR I表现规律,显示直肠癌、直肠系膜筋膜内淋巴结与环周切缘的关系,并测量肿块、淋巴结与环周切缘的距离,进一步评估直肠癌局部浸润深度及范围。结果 MRI诊断T_1期7例、T_2期11例、T_3期11例、T_4期6例,与病理结果的6例、9例、13例、7例一致性较高。直肠系膜筋膜MR I薄层扫描在诊断直肠癌时,判断病变位置、范围以及局部浸润深度及范围接近手术病理结果(P>0.05)。结论应用直肠系膜筋膜MRI薄层检查能够提高临床诊断准确率和直肠癌的局部浸润和局部分期,对手术边缘有无累及情况进行判断,清晰显示病灶以及邻近浸润状况,为临床治疗提供可靠的依据,应当进一步推广应用。

Objective To evaluate the clinical value of thin layer MRI examination of mesorectal fascia in the infiltration of rectal cancer.Methods From october2014to February2018,35patients with rectal cancer were selected.The location and range of rectal cancer were accurately measured.The MRI findings of rectal cancer and its surrounding structures were observed.The relationship between rectal cancer,mesorectal intrafascial lymph node and circumferential margin was revealed.The distance between tumor,lymph node and circumferential margin was measured.The depth and extent of local invasion of rectal cancer were further evaluated.Results MRI diagnosis of stage T1in7cases,stage T2in11cases,stage T3in11cases,stage T4in6cases,and pathological results of6cases,9cases,13cases,7cases of high consistency.Thin-slice MRI of mesorectal fascia can accurately determine the location,extent,depth and extent of local infiltration in the diagnosis of rectal cancer,which is close to the results of surgery and pathology(P>0.05).Conclusion The application of thin-layer MRI of mesorectal fascia can improve the accuracy of clinical diagnosis,local invasion and staging of rectal cancer,judge whether the surgical margin is involved or not,clearly show the lesions and adjacent infiltration,and provide reliable basis for clinical treatment.It should be further promoted and applied.