Imaging of both benign and malignant anorectal diseases has traditionally posed a challenge to clinicians, and as a result history and physical exam have been relied on heavily. CT scanning and endorectal ultrasound h...Imaging of both benign and malignant anorectal diseases has traditionally posed a challenge to clinicians, and as a result history and physical exam have been relied on heavily. CT scanning and endorectal ultrasound have become popular in assessment of anatomy and staging of tumors, but have limitations. Magnetic resonance imaging (MRI) has the capability to fill in the gaps left open by more conventional imaging modalities and continues to be promising as the definitive imaging technique in the pelvis, especially with advancement of emerging technologies in this field. A comprehensive review of this topic has been undertaken. Anorectal disease is divided into three broad categories: cancer, fistula/abscess, and pelvic floor disorders. A review of the literature is performed to evaluate the use of MRI and other imaging modalities in these three areas. Preoperative imaging is useful in the evaluation of all three areas of anorectal disease. MRI is an effective tool in delineating anatomy and, when correlating with the specific clinical scenario, is an effective adjunct in clinical decision-making in order to optimize outcome. MRI continues to be a promising and novel approach to imaging various afflictions of the anorectum and the pelvic floor. Its role is more well-established in some areas than in others, and there are still signif icant limitations. As technology advances, MRI will shed more light on a complex anatomical area.展开更多
Objective： The aim of our study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging （DMRI） in predicting early response to neoadjuvant chemotherapy （NAC） in patients with locally advan...Objective： The aim of our study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging （DMRI） in predicting early response to neoadjuvant chemotherapy （NAC） in patients with locally advanced breast cancer （LABC） and to assess the accuracy of DMRI in evaluating residual disease after NAC. Methods： DMRI were per- formed in 43 women with LABC （44 lesions, all were invasive ductal carcinoma） before, after the first and final cycle of NAC. Tumour volume, early enhanced ratio （El）, maximum enhanced ratio （Emax）, and maximum enhanced time （Tmax）, dynamic signal intensity-time curve were obtained during treatment. Residual tumour volumes obtained using DMRI were compared with pathological findings to assess the accuracy of DMRI. Results： After 1st cycle of NAC, the mean volume of responders decreased insignificantly, P 〉 0.05, but after NAC, mean volume of residual tumor decreased significantly （P 〈 0.01）. Morphol- ogy change： 29 cases showed a concentric shrinkage pattern while 7 cases showed a dendritic shrinkage pattern. Significant differences were found in El, Emax and Tmax between responders and non-responders （P 〈 0.05）. After 1st cycle of NAC, El, Emax and Tmax of responders changed significantly （P 〈 0.001）; while there is no significant change in non-responders （P 〉 0.05）. After NAC, dynamic signal intensity-time types were changed in responders, and tended to be significantly flat- tening, while no significant change was found in non-responders. The residual tumour volume correlation coefficient between DMRI and pathology measurements was very high （r = 0.866, P = 0.000）. Conclusion： DMRI is useful to evaluate the early response to NAC in LABC. The presence and volume of residual disease in LABC patients treated with NAC could be ac- curately evaluated by DMRI.展开更多
文摘Imaging of both benign and malignant anorectal diseases has traditionally posed a challenge to clinicians, and as a result history and physical exam have been relied on heavily. CT scanning and endorectal ultrasound have become popular in assessment of anatomy and staging of tumors, but have limitations. Magnetic resonance imaging (MRI) has the capability to fill in the gaps left open by more conventional imaging modalities and continues to be promising as the definitive imaging technique in the pelvis, especially with advancement of emerging technologies in this field. A comprehensive review of this topic has been undertaken. Anorectal disease is divided into three broad categories: cancer, fistula/abscess, and pelvic floor disorders. A review of the literature is performed to evaluate the use of MRI and other imaging modalities in these three areas. Preoperative imaging is useful in the evaluation of all three areas of anorectal disease. MRI is an effective tool in delineating anatomy and, when correlating with the specific clinical scenario, is an effective adjunct in clinical decision-making in order to optimize outcome. MRI continues to be a promising and novel approach to imaging various afflictions of the anorectum and the pelvic floor. Its role is more well-established in some areas than in others, and there are still signif icant limitations. As technology advances, MRI will shed more light on a complex anatomical area.
文摘Objective： The aim of our study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging （DMRI） in predicting early response to neoadjuvant chemotherapy （NAC） in patients with locally advanced breast cancer （LABC） and to assess the accuracy of DMRI in evaluating residual disease after NAC. Methods： DMRI were per- formed in 43 women with LABC （44 lesions, all were invasive ductal carcinoma） before, after the first and final cycle of NAC. Tumour volume, early enhanced ratio （El）, maximum enhanced ratio （Emax）, and maximum enhanced time （Tmax）, dynamic signal intensity-time curve were obtained during treatment. Residual tumour volumes obtained using DMRI were compared with pathological findings to assess the accuracy of DMRI. Results： After 1st cycle of NAC, the mean volume of responders decreased insignificantly, P 〉 0.05, but after NAC, mean volume of residual tumor decreased significantly （P 〈 0.01）. Morphol- ogy change： 29 cases showed a concentric shrinkage pattern while 7 cases showed a dendritic shrinkage pattern. Significant differences were found in El, Emax and Tmax between responders and non-responders （P 〈 0.05）. After 1st cycle of NAC, El, Emax and Tmax of responders changed significantly （P 〈 0.001）; while there is no significant change in non-responders （P 〉 0.05）. After NAC, dynamic signal intensity-time types were changed in responders, and tended to be significantly flat- tening, while no significant change was found in non-responders. The residual tumour volume correlation coefficient between DMRI and pathology measurements was very high （r = 0.866, P = 0.000）. Conclusion： DMRI is useful to evaluate the early response to NAC in LABC. The presence and volume of residual disease in LABC patients treated with NAC could be ac- curately evaluated by DMRI.
