中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
3期
235-238
,共4页
直肠肿瘤,低位%磁共振成像%肛门括约肌复合体%肛管浸润%手术方式
直腸腫瘤,低位%磁共振成像%肛門括約肌複閤體%肛管浸潤%手術方式
직장종류,저위%자공진성상%항문괄약기복합체%항관침윤%수술방식
Rectal neoplasms,low%Magnetic resonance imaging%Anal sphincter complex%Anal canal invasion%Surgical procedures
目的 评估高分辨磁共振成像(MRI)对低位直肠癌肛管浸润情况的判断价值,为手术层面的界定提供参考.方法 23例经病理证实的低位直肠癌患者和20例无肛管疾病的对照患者行盆腔3.0T MRI表面相控阵线圈检查.MRI扫描序列包括高分辨T2WI序列(TSE-T2WI)和三维容积内插动态增强序列(3D-VIBE).总结正常肛管MRI高分辨图像特征及直肠癌浸润肛管影像学特征,并对直肠癌进行T分期及T-DACI分期(肿瘤浸润肛门括约肌复合体的深度).结果 20例对照组患者中,除8例联合纵肌显示欠清外,其余12例MRI下肛门括约肌复合体的7层解剖结构显示清晰.23例低位直肠癌浸润肛门括约肌复合体表现为相应解剖层面正常信号消失代之于稍高信号肿瘤组织,正常解剖层次结构消失,代之于肿块影.23例低位直肠癌患者术前影像学T分期(耻骨直肠肌上方):T2期8例,T3期7例,T4期8例;T-DACI分期(耻骨直肠肌下方):T0-DACI期10例,T1-DACI期1例,T2a-DACI期3例,T2-DACI期3例,T3-DACI期4例,T4-DACI期2例.8例影像学诊断为T0-2a-DACI期患者行一期直肠癌切除术,其中6例术后病理学分期与术前影像学分期一致,另2例T2a-DACI病例术后病理证实为pT3期.结论 高分辨MRI能够较准确地判断低位直肠癌肛管浸润情况,从而为手术层面的界定提供依据和参考.
目的 評估高分辨磁共振成像(MRI)對低位直腸癌肛管浸潤情況的判斷價值,為手術層麵的界定提供參攷.方法 23例經病理證實的低位直腸癌患者和20例無肛管疾病的對照患者行盆腔3.0T MRI錶麵相控陣線圈檢查.MRI掃描序列包括高分辨T2WI序列(TSE-T2WI)和三維容積內插動態增彊序列(3D-VIBE).總結正常肛管MRI高分辨圖像特徵及直腸癌浸潤肛管影像學特徵,併對直腸癌進行T分期及T-DACI分期(腫瘤浸潤肛門括約肌複閤體的深度).結果 20例對照組患者中,除8例聯閤縱肌顯示欠清外,其餘12例MRI下肛門括約肌複閤體的7層解剖結構顯示清晰.23例低位直腸癌浸潤肛門括約肌複閤體錶現為相應解剖層麵正常信號消失代之于稍高信號腫瘤組織,正常解剖層次結構消失,代之于腫塊影.23例低位直腸癌患者術前影像學T分期(恥骨直腸肌上方):T2期8例,T3期7例,T4期8例;T-DACI分期(恥骨直腸肌下方):T0-DACI期10例,T1-DACI期1例,T2a-DACI期3例,T2-DACI期3例,T3-DACI期4例,T4-DACI期2例.8例影像學診斷為T0-2a-DACI期患者行一期直腸癌切除術,其中6例術後病理學分期與術前影像學分期一緻,另2例T2a-DACI病例術後病理證實為pT3期.結論 高分辨MRI能夠較準確地判斷低位直腸癌肛管浸潤情況,從而為手術層麵的界定提供依據和參攷.
목적 평고고분변자공진성상(MRI)대저위직장암항관침윤정황적판단개치,위수술층면적계정제공삼고.방법 23례경병리증실적저위직장암환자화20례무항관질병적대조환자행분강3.0T MRI표면상공진선권검사.MRI소묘서렬포괄고분변T2WI서렬(TSE-T2WI)화삼유용적내삽동태증강서렬(3D-VIBE).총결정상항관MRI고분변도상특정급직장암침윤항관영상학특정,병대직장암진행T분기급T-DACI분기(종류침윤항문괄약기복합체적심도).결과 20례대조조환자중,제8례연합종기현시흠청외,기여12례MRI하항문괄약기복합체적7층해부결구현시청석.23례저위직장암침윤항문괄약기복합체표현위상응해부층면정상신호소실대지우초고신호종류조직,정상해부층차결구소실,대지우종괴영.23례저위직장암환자술전영상학T분기(치골직장기상방):T2기8례,T3기7례,T4기8례;T-DACI분기(치골직장기하방):T0-DACI기10례,T1-DACI기1례,T2a-DACI기3례,T2-DACI기3례,T3-DACI기4례,T4-DACI기2례.8례영상학진단위T0-2a-DACI기환자행일기직장암절제술,기중6례술후병이학분기여술전영상학분기일치,령2례T2a-DACI병례술후병리증실위pT3기.결론 고분변MRI능구교준학지판단저위직장암항관침윤정황,종이위수술층면적계정제공의거화삼고.
Objective To evaluate high resolution MR in imaging of the anatomy and tumor invasion of the anal canal.Methods Twenty-three patients with low rectal cancer confirmed by pathology results were recruited as the study group and 20 patients without history of anal canal diseases were recruited as the control group.All patients received MRI examinations containing three TSE-T2WI sequences and three 3D-VIBE sequences.The distance between the tumor and the anal margin was measured in the study group.Two radiologists finished T staging of the tumor independently.Results MRI had a clear demonstration of the anatomy of the anal canal in all 20 control patients.The T staging of 23 patients of study group was T2 (n=8),T3 (n=7),and T4 (n=8),and the depth of anal canal invasion (T-DACI) was T0-DACI (n=10),T1-DACI (n=1),T2a-DACI (n=3),T2-DACI (n=3),T3-DACI (n=4) and T4-DACI (n=2).Eight patients received surgery and the consistency between pathological staging and imaging staging was 75％.Conclusion High resolution MRI has the capacity of demonstrating the complex anatomy of the anal canal,and can provide evidence of anal canal invasion for low rectal cancer.
