【摘要】 目的探讨3.0 T MR多序列成像评估食管鳞状细胞癌是否侵犯胸主动脉、气管或支气管,以判断肿瘤的可切除性。方法搜集经内镜活检证实的鳞状细胞癌45例,术前均行3.0 T MRI T1WI、脂肪抑制T2WI、动态增强扫描,评价食管鳞状细胞癌与周围结构的解剖关系,并与手术病理结果进行对照。结果 (1)若结合"夹角法"和"三角法"判断胸段食管癌侵犯胸主动脉壁,灵敏度、特异度、准确度高达97.6%、100%、97.8%。用"三角法"判断胸段食管癌侵犯胸主动脉壁,灵敏度、特异度、准确度高达95.2%、100%、95.6%;用"夹角法"判断胸段食管癌侵犯胸主动脉壁,其灵敏度、特异度、准确度分别为100%、0、97.4%。(2)以肿瘤与气管或支气管之间的脂肪间隙消失且其接触长度>3 cm为标准来判断食管癌侵犯气管或支气管,灵敏度、特异度、准确度分别为97.6%、100%、97.8%。结论高场强MR多序列成像有助于判断食管鳞状细胞癌是否侵犯胸主动脉、气管或支气管,以判断肿瘤的可切除性。更多还原

【Abstract】 Objective To evaluate the resectability of esophageal squamous cell carcinoma based on the involvement of the thoracic aorta wall and of the trachea or bronchi by using multiple sequences of 3. 0T magnetic resonance imaging.Methods Forty five patients with esophageal squamous cell carcinoma confirmed by endoscopic biopsy were enrolled into our study. All patients underwent preoperative T1 weighted imaging,fat suppressed T2 weighted imaging,and dynamic contrast enhanced scans using a 3. 0T magnetic resonance scanner. Based on the imaging data,the anatomic relationships of esophageal squamous cell carcinoma with the adjacent structures were reviewed,the image findings were compared with the surgically pathologic results. Results If the"angle method"and"triangulation method"were combined as the reference standards to review the esophageal carcinoma involving the thoracic aorta wall,the sensitivity,specificity and accuracy were 97. 6%,100% and 97. 8% respectively. The sensitivity,specificity and accuracy of the determination of thoracic esophageal squamous cell carcinoma involving the thoracic aorta wall were as high as 95. 2%,100% and 95. 6% by using the "triangle method"as the reference standard respectively. When"angle method"was used as the reference standard to determine the esophageal carcinoma involving the thoracic aorta wall,the sensitivity,specificity and accuracy were 100%,0 and 97. 4% respectively. When the disappearance of fat gap between the esophageal tumor and the trachea or bronchi,and the contact length of more than 3cm between this tumor and the airway were used as the reference standard to review the thoracic esophageal squamous cell carcinoma involving the airway,the sensitivity,specificity and accuracy were 97. 6%,100% and 97. 8% respectively. Conclusion Multiple imaging sequences of 3. 0T magnetic resonance system can be valuable to determine the feasibility of thoracic esophageal squamous cell carcinoma involving the thoracic aorta wall and of the trachea or bronchi to assess the resectability of this cancer.更多还原