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直肠癌是消化道系统常见恶性肿瘤,依据直肠癌的不同分期采用不同的治疗方法,术前准确判断直肠癌分期是合理制定治疗方案的关键。目前,在国内用于直肠癌术前分期的影像学检查方法主要有CT、MRI和超声内镜。任何一种影像检查方法都有其自身的优势和不足,没有哪种方法可以对直肠癌分期的各个方面的诊断均作出满意的回答。直肠癌T分期,目前较好的影像学检查方法主要是腔内超声和MRI,尤其是T分期较早病例,腔内超声分期更准确,进展期直肠癌和N分期,MRI有一定优势。对于M分期,CT和MRI都能满足临床需要,但CT对于腹部其他结构的显示更清晰,同时,还可以一次完成腹、盆腔检查。MRI具有较好的T、N分期能力的同时,还可以准确显示直肠癌TME手术相关的精细解剖结构,准确评估癌肿边缘与直肠系膜筋膜、肛门及盆腔腹膜反折等邻近解剖结构的关系,对于决定治疗方案和TME手术效果价值较大。
Rectal cancer is a common malignant tumor of the digestive system. Depending on the stage of rectal cancer, different treatment methods are used. Accurately determining the stage of rectal cancer before surgery is the key to the rational formulation of the treatment plan. At present, there are CT, MRI and endoscopic ultrasonography in the domestic imaging examination methods for preoperative staging of rectal cancer. Any imaging method has its own advantages and disadvantages, and there is no way to make a satisfactory answer to all aspects of the diagnosis of rectal cancer staging. T staging of rectal cancer, the best imaging method is mainly intracavity ultrasound and MRI, especially the earlier cases of T staging, intracavitary ultrasound staging more accurate, advanced rectal cancer and N staging, MRI has some advantages. For the M staging, CT and MRI can meet the clinical needs, but CT for other structures of the abdomen show clearer, at the same time, you can also complete a pelvic examination. While MRI has good T and N staging capabilities, it can also accurately display the fine anatomy related to TME for rectal cancer and accurately evaluate the relationship between the edge of the cancer and the adjacent anatomical structures such as mesorectal fascia, anus and pelvic peritoneal reflex , For the decision of treatment and TME surgery greater value.