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目的:将水脂分离增强扫描序列应用于直肠癌磁共振术前分期检查,探讨其在直肠癌术前分期中的应用价值。方法:选择经肠镜活检证实为直肠癌患者46例,随机盲法均分为两组,一组序列采用常规序列及T1脂肪抑制增强扫描序列;另一组序列采用常规序列及水脂分离增强扫描序列,结果与病理分期对照,比较两组序列图像信噪比及T、N分期。结果:组一T分期总敏感度为74%,特异度为78%。N分期总敏感度为74%,特异度为74%;N0分期敏感度78.6%,特异度66.7%,准确率为78%;N1分期敏感度57%,特异度81%,准确率为71%;N2分期敏感度100%,特异度100%,准确率为100%。组二T分期总敏感度为83%、特异度为83%;N分期总敏感度91%,特异度为91%;N0分期敏感度94%,特异度83%,准确率为94%;N1分期敏感度75%,特异度95%,准确率为75%;N2分期敏感度100%,特异度94.5%,准确率为100%。结论:水脂分离序列可提高图像信噪比,脂相有助于提高N分期,此序列在直肠癌术前分期中具有一定的临床应用价值。
OBJECTIVE: To apply the water-fat separation enhanced scan sequence to preoperative MR staging of rectal cancer and to explore its value in the preoperative staging of rectal cancer. Methods: Forty-six patients with rectal cancer confirmed by colonoscopy were divided into two groups according to randomized blind method. One group had normal sequence and T1 fat suppression enhanced sequence. The other sequence was enhanced by routine sequence and water-lipid separation Scanning sequence, the results and pathological staging control, comparing two groups of sequence signal to noise ratio and T, N staging. Results: The T-stage group had a total sensitivity of 74% and a specificity of 78%. N stage staging sensitivity and specificity of 74%; N0 staging sensitivity 78.6%, specificity 66.7%, accuracy 78%; N1 staging sensitivity 57%, specificity 81%, accuracy 71% ; N2 staging sensitivity of 100%, specificity of 100%, the accuracy rate of 100%. Group T had a total sensitivity of 83% and a specificity of 83% for T stage. The overall sensitivity was 91% for N stage and 91% for specificity. The sensitivity, specificity and accuracy of N0 staging were 94%, 83% and 94% respectively. N1 Staging sensitivity 75%, specificity 95%, accuracy 75%; N2 staging sensitivity 100%, specificity 94.5%, the accuracy rate of 100%. Conclusion: The water-lipid separation sequence can improve the image signal-to-noise ratio, and the lipid phase can help to improve the N stage. This sequence has some clinical value in the preoperative staging of rectal cancer.