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目的探讨腔内线圈MRI和相控阵线圈在直肠癌T分期中的应用价值。资料与方法经全直肠系膜切除术(TME)的直肠癌患者36例(男21例,女15例,年龄32～68岁,平均48岁)。术前行相控阵线圈高分辨MRI及术后直肠标本腔内线圈MRI,以手术病理为标准,计算两种线圈对直肠癌T分期的准确率。结果肿瘤在T2WI上呈稍低信号,直肠上段8例,中下段22例,下段6例。MRI软质相控阵线圈T分期判断总准确率约80.6%(29/36)。其中T2期准确率50%(3/6),高估50%;T3期准确率86.4%(19/22),低估4.5%(1/22),高估9.9%(2/22);T4期准确率87.5%(7/8),低估12.5%(1/8)。直肠腔内线圈T分期判断总准确率约77.8%(28/36)。T2期准确率83.3%(5/6),高估16.7%(1/6);T3期准确率95.4%(21/22),低估4.5%(1/22);T4期准确率25%(2/8),低估75%(6/8)。两种线圈结合总的T分期判断的准确率为91.7%(33/36)。T2期准确率83.3%(5/6),T3期准确率为95.4%(21/22),T4期准确率87.5%(7/8)。结论相控阵线圈T2、T3期肿瘤准确率不及腔内线圈,T4期肿瘤准确率高于腔内线圈,二者结合可以提高T2、T4期直肠癌T分期的准确率,但总的T分期准确率提高不明显。
Objective To investigate the value of intracavitary coil MRI and phased array coil in T staging of rectal cancer. Materials and Methods Thirty-six patients (21 males and 15 females, aged 32-68 years, mean 48 years) underwent total mesorectal excision (TME) with rectal cancer. Preoperative phased array coil high resolution MRI and postoperative rectal specimen intracavitary coil MRI, surgical pathology as the standard, calculate the two coils of T staging accuracy of rectal cancer. Results The tumor showed a slightly lower signal on T2WI. There were 8 cases of upper rectum, 22 cases of middle and lower rectum, and 6 cases of lower rectum. MRI soft phased array T staging to determine the total accuracy of about 80.6% (29/36). The accuracy rate of T3 was 86.4% (19/22), underestimation of 4.5% (1/22), and overestimation of 9.9% (2/22), while the accuracy of T2 was 50% (3/6) Accuracy of 87.5% (7/8), underestimation of 12.5% (1/8). The total accuracy of T staging in rectal cavity was 77.8% (28/36). T2 accuracy of 83.3% (5/6), overestimation of 16.7% (1/6); T3 accuracy of 95.4% (21/22), underestimation of 4.5% (1/22); T4 accuracy of 25% 2/8), an underestimation of 75% (6/8). The accuracy of the two coils combined with the total T stage was 91.7% (33/36). The accuracy rate of T2 was 83.3% (5/6), the accuracy of T3 was 95.4% (21/22), and the accuracy of T4 was 87.5% (7/8). Conclusion The accuracy of tumor in phase T2 and T3 phased array coils is less than that of intracavitary coils, and the accuracy of tumor in T4 phase is higher than that in intracavitary coil. The combination of the two can improve the accuracy of T staging of T2 and T4 rectal cancer, but the total T stage The accuracy is not obvious.