直肠CA的MRI分期RS讲座总结.pptVIP

Rectal Cancer - MR imagingMR staging Publicationdate December 19, 2010 Introduction Total mesorectal excision Circumferential resection margin Location of the tumor Low rectal cancer T-stage and mesorectal fascia (MRF) T1 and T2 / T3 MRF- / T3 MRF+ / T4 N-stage MR protocol Radiological report A. Primary staging B. Restaging after neoadjuvant treatment Treatment Cases Traditionally rectal cancer surgery total mesorectal excision (TME) neoadjuvant radiochemotherapy Total mesorectal excision (TME) Total mesorectal excision (TME) is the best surgical treatment for rectal cancer provided that the resection margin is free of tumor. The shortest distance from the tumor or lymph nodes to the mesorectal fascia is called the cirumferential resection margin (CRM). the most powerful predictor for local recurrence ＜1mm involved 1-2mm threatened ＞2mm not threatened Circumferential resection margin（CRM） CRM对于对直肠癌尤为重要。CRM的准确评估不单是包括新辅助治疗患者内在的局部复发的预测指标，也是总生存率的直接预测因子，对于术后决策也是有举足轻重的作用。 Rectal Cectal Cancer-MR imaging Introduction Total mesorectal excision Circumferential resection margin Location of the tumor Low rectal cancer T-stage and mesorectal fascia (MRF) T1 and T2 / T3 MRF- / T3 MRF+ / T4 N-stage MR protocol Radiological report A. Primary staging B. Restaging after neoadjuvant treatment Treatment Cases Location of the tumor Low rectal cancer: 0- 5 cm from the anorectal angle Mid rectal cancer: 5-10 cm from the anorectal angle High rectal cancer: 10-15 cm from the anorectal angle Low rectal cancer Low rectal cancer has a higher local recurrence rate. more easily invades the surrounding structures and it will be more difficult for the surgeon to get a tumor free resection . Introduction Total mesorectal excision Circumferential resection margin Location of the tumor Low rectal cancer T-stage and mesorectal fascia (MRF) T1 a