中国实用外科杂志2017，Vol.37Issue(6)：605-609,5.DOI:10.19538/j.cjps.issn1005-2208.2017.06.04
低位直肠癌磁共振影像学分期的精确评估
Precise assessment of low rectal cancer by magnetic resonance imaging
王屹1
作者信息
- 1. 北京大学人民医院放射科,北京100029
- 折叠
摘要
Abstract
The primary strategy for low rectal cancers is curative operation.In results of anatomic characteristics,low rectal cancers treated with abdominoperineal excision (APE) have a higher rate of margin involvement compared with tumours elsewhere in the rectum.It is necessary to analyze the relationship between low rectal cancer and surrounding structures and organs before operation.High-resolution magnetic resonance imaging (MRI) can be used to assess risk factors related with margin involvement,including tumor extended to full thickness of the muscularis propria/internal sphincter,extends into the intersphincteric plane,or extends into the external sphincter or ＜ 1 mm from levator ani,anterior quarter invasion,extramural vascular invasion,and less than 4cm from anal verge.Risk factors can be used to correct surgical management to minimize the rate of margin involvement.Local control rate of rectal cancer has been improved after neoadjuvant chemoradiation and even pathological completed response (pCR) has been demonstrated in a significant minority.If the patients with clinical completed response to neoadjuvant chemoradiation can be demonstrated by clinical and medical imaging findings,a nonoperative management (NOM) strategy has been pursued to preserve sphincter function and avoid complications induced by surgery.MRI could be used to assess completed response of rectal cancer to neoadjuvant chemoradiotherapy.The Future research must focus on the integration of morphological and functional imaging with clinical data and molecular biomarkers.关键词
磁共振影像/低位直肠癌Key words
magnetic resonance imaging/low rectal cancer分类
医药卫生引用本文复制引用
王屹..低位直肠癌磁共振影像学分期的精确评估[J].中国实用外科杂志,2017,37(6):605-609,5.
