- 期刊
- OpenAccess
Application of Magnetic Resonance Images in Gastrointestinal Malignancies
核磁共振掃描在腸胃道惡性腫瘤之應用
摘要
本研究透過33名經由內視鏡和生檢診斷為胃、十二指腸或大腸直腸惡性腫瘤之患者，接受磁振共振掃描，以評估核磁共振在偵測腫瘤侵犯深度、局部淋巴轉移及肝臟轉移等臨床上的實用性。在進行核磁共振掃描前一週內，多數患者亦同時接受消化道攝影或電腦斷層掃描。其後，我們針對核磁共振掃描、電腦斷層掃描與手術結果，進行腫瘤局部侵犯範圍、漿膜外侵犯、局部淋巴轉移、遠處轉移等各方面的比較與分析。 由於核磁共振能夠彌補電腦斷層掃描在組織對比解像力與多平面掃描兩方面的不足，故研究顯示，核磁共振的確有助於精確偵測出局部腫瘤侵犯之範圍。對於腫瘤導致胃出口或大腸腸道阻塞之病例，其殘留的鋇劑常會影響後繼的電腦斷層檢查，但核磁共振卻能夠提供具診斷價值的清晰影像；在此情況下，消化道鋇劑攝影只能顯現出腸道阻塞的情況，但核磁共振卻能精確地指出病灶之所在。此外，核磁共振與電腦斷層相同，均具有偵測局部淋巴轉移和肝臟轉移的能力。是故，本研究認為，對於腸胃道惡性腫瘤之術前評估，當電腦斷層掃描與消化道攝影不足以診斷時，核磁共振可以取代其二者之功能。
並列摘要
Thirty three patients, who were previously documented to have gastric, duodenal or colorectal malignancies by endoscopy and biopsy, underwent magnetic resonance imaging (MRT) to evaluate the clinical usefulness of MRI on assessing depth of invasion, regional lymphadenopathy and hepatic metastasis. Most of these patients had undergone either barium or computed tomography (CT) studies within one week before the MR imaging. The MRI, CT, and operative findings including tumor extension, extraserosal invasion, regional lymph nodes and regional or distant metastases were compared. The results showed that MRI provided advantages over CT for determining local invasion because of high tissue contrast and multiplanar imaging capacity. In addition, MRI provided high quality images in the patient with gastric outlet or colonic obstruction that the retained barium might prohibit subsequent CT scan. In such situations, barium studies only showed the obstruction; however, the lesion would be better depicted by MRI. Furthermore, MRI was comparable to CT in showing regional lymphadenopathy and hepatic metastasis. As a result, it is suggested that MRI has the potential to replace the combination of barium study and CT for preoperative staging of gastrointestinal malignancies in the situation when the latters may not be performed optimally.