磁共振成像对直肠癌患者术后局部复发的临床诊断价值.docxVIP

磁共振成像对直肠癌患者术后局部复发 的临床诊断价值 张玉英马骏 沈阳医学院附属中心医院放射线科沈阳医学院附属 中心医院普外四科 摘要： 目的探讨磁共振成像对直肠癌患者术后局部复发的临床诊断效果。方法选取 2015年5月至2017年5月间沈阳医学院附属中心医院收治的90例直肠癌术后 局部复发的患者，均接受直肠癌根治术+常规化疗。采用磁共振成像（MRT）与电 子计算机断层扫描（CT）进行诊断，比较两种方法诊断直肠癌患者术后局部复 发的准确性、特异性及灵敏性。结果MRI诊断直肠癌患者术后复发的准确性、 灵敏性和特异性分别为91. 1%、86. 7%和73. 3%, CT诊断分别为75. 6%、66. 7%和 60. 0%, MRI较CT诊断结果均较高，差异均有统计学意义（均P0. 05）。直肠癌 患者术后局部复发的MRI征象为:紙前分叶状肿块，T1WI呈低信号，T2WI及弥散 加权（DWI）呈高信号，増强扫描不均匀或环形强化。CT征象为:紙前出现密度 分布不均的团组织肿块，增强扫描可见中心坏死、边缘高低不平的环状强化，吻 合口出处不规则增厚，腔隙变窄，伴有盆腔组织受累。结论MRI诊断直肠癌患 者术后局部复发相比CT,具有较高的准确性及灵敏性，为术后复发的治疗可提 供合理依据。 关键词： 磁共振成像;直肠肿瘤;术后局部复发; 作者简介：张玉英，女，主治医师，主要从事放射线影像诊断专业。 收稿日期:2017-06-19 Magnetic resonance imaging for diagnosing postoperative local recurrence of rectai cancer ZHANG Yu-ying MA Jun Department ofRadio1ogy, CentralHospital Affiliated to Shenyang Medical College; Fourth Department of General Surgery, Central Hospital Affiliated to Shenyang Medical College; Abstract： Objective To explore and analyze the effectivcncss of magnctic resonance imaging ( MR1) for diagnosing postoperative local recurrence of rectal cancer? Methods From May 2015 to May2017, 90 patients with postoperative local recurrenee of rectal cancer treated at Affiliated Hospitals to Shenyemg Medical Col lege were selected. Al 1 the patients received radical rcscction of rectal cancer and routine chcmothcrapy. ComputcT tomography (CT) and MR1 diagnosis were performed. The accuracy, specificity and sensitivity of the two diagnostic methods were compared for postoperative local recurrence of rectal cancer. Results The accuracy, specificity and sensitivity of MRT was 91. 1%, 86. 7% and 73. 3%, respectively, which was higher than 75. 6%, 66. 7% and 60. 0%, respectively of CT in the diagnosis of postoperative local recurrence of rectal cancer. The MR I indication for postoperative local recurrence of rectai cancer included lobulated sacral mass, TI WI low signal, T2 WI and diffusion weighted ( DWI) high signal, uneven enhancement scan or circular reinforcement. The CT indicat