以充氣式磁振攝影評估大腸癌之局部擴散－病例報告

本研究透過9名經由內視鏡與生檢診斷為大腸直腸惡性腫瘤之患者接受磁振造影掃描，以評估磁振造影在偵測腫瘤侵犯部位之臨床上的實用性。以半傅利葉轉換截取單次激發快速自旋回波(Half-Fourier Acquisition Single-Shot Turbo Spin Echo; HASTE)取得更為精準之冠狀切面；以T1波序取得病灶橫斷面之影像。這些患者在手術前都有接受電腦斷層攝影及大腸攝影。良好的充氣式大腸磁振造影不僅能讓大腸癌術前影像多一種參考及比較，亦可作為病理分期最好的標準對照。由於磁振造影能彌補電腦斷層掃描在組織對比解析力與多平面方式掃描兩方面的不足，且大腸攝影只能提供鋇劑阻塞的情況，但磁振造影卻能確定的檢查出病灶的所在。因此，我們的研究結果建議，充氣式大腸磁振造影之影像或許可以充實當前大腸癌術前影像之參考，進一步幫助醫師於大腸癌手術前影像分期之評估。

關鍵字

大腸直腸惡性腫瘤；磁振造影掃描；大腸攝影；充氣式大腸磁振造影

並列摘要

Nine patients, who were previously diagnosed to have colorectal malignancies by endoscopy and biopsy, underwent magnetic resonance imaging (MRI) with air enema to evaluate the clinical usefulness of MRT on assessing depth of invasion. Coronal and transverse imaging of the air-inflated colon was performed with Half-Fourier Acquisition Single-Shot Turbo Spin Echo (HASTE) sequence and Ti sequence. These patients also underwent barium enema and abdominal computed tomography (CT) as preoperative staging work-ups. The usefulness of air-inflated magnetic resonance colonography was compared with other preoperative imaging studies with pathologic staging as the gold standard for comparison. The results showed that MRI provided advantages over CT for determining local invasion because of high tissue contrast and multiplanar imaging capacity. In colon cancer presenting with retrograde obstruction during barium enema, the tumor was better depicted by MR colonography. Our results suggest that MR imaging with the use of air as a negative contrast agent may be useful for preoperative staging of colorectal carcinoma and supplement to current preoperative imaging work-ups.

並列關鍵字

colorectal malignancies ； magnetic resonance imaging ； colonography ； air-inflated magnetic resonance colonography

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以充氣式磁振攝影評估大腸癌之局部擴散－病例報告

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