文章摘要

3.0 T MRI对新辅助化疗后食管癌术前T分期的准确性及组织病理学相关性

作者: 1赵峰, 2朱军, 1郭楠楠, 1刘燕文
1 东南大学附属中大医院江北院区肿瘤科,南京 210044
2 江苏省肿瘤医院放疗科,南京 210009
通讯: 赵峰 Email: zhaohua248@163.com
DOI: 10.3978/j.issn.2095-6959.2019.12.014
基金: 江苏省卫生与计划生育委员会2017年医学科研课题(H201708)。

摘要

目的:探讨3.0 T磁共振成像对新辅助化疗食管癌术前T分期及组织病理学分期一致性的价值。方法:前瞻性纳入2017年1月至2018年12月期间79例食管癌患者。患者均接收2周期新辅助化疗后再接收3.0 T MRI检查及根治性手术。2位不同的阅片人员分别对T2加权TSE BLADE、增强StarVIBE、高分辨率StarVIBE延迟扫描上病灶T分期进行判断。结果:新辅助化疗结束至MRI检查间隔时间为(23±2) d。在T2加权TSE BLADE扫描中,2位阅片人的判断准确性最高(κ=0.810,P<0.0001)。T2加权TSE BLADE、增强StarVIBE、高分辨率StarVIBE延迟扫描对术后组织病理学T分期的诊断准确率分别为86.1%~96.2%,86.1%~94.9%,86.1%~96.2%。高分辨率StarVIBE延迟扫描在对T0,T1,T2,T4的判断价值最高,而T2加权TSE BLADE对T3病变的判断价值最高。结论:除T3期病变外,T2加权TSE BLADE序列在明确新辅助化疗后食管癌病变T分期方面具有更高的精准度。T2加权TSE BLADE、增强StarVIBE和高分辨率StarVIBE延迟扫描三者联合不能进一步提高诊断准确性。
关键词: 食管癌;T2加权TSE BLADE;增强StarVIBE;高分辨率StarVIBE延迟扫描

Accuracy of 3.0 T MRI for preoperative T staging of esophageal cancer after neoadjuvant chemotherapy and its relation with histopathology

Authors: 1ZHAO Feng, 2ZHU Jun, 1GUO Nannan, 1LIU Yanwen
1 Department of Oncology, Jiangbei Campus, Zhongda Hospital Affiliated to Southeast University, Nanjing 210044, China
2 Department of Radiation Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China

CorrespondingAuthor: ZHAO Feng Email: zhaohua248@163.com

DOI: 10.3978/j.issn.2095-6959.2019.12.014

Foundation: This work was supported by Jiangsu Provincial Health and Family Planning Commission 2017 Medical Research Project, China (H201708).

Abstract

Objective: To explore the value of 3.0T MRI for evaluating the preoperative T staging of esophageal cancer (EC) treated with neoadjuvant chemotherapy (NAC), with histopathologic confirmation. Methods: A total of 79 patients with EC from January 2017 to December 2018 were prospectively included. All patients received 2 cycles of NAC. After NAC, all patients received 3.0 T MRI examination and radical surgery. Two different reviewers judged the T staging of lesions on T2-weighted TSE BLADE, enhanced StarVIBE and high resolution StarVIBE delayed scanning respectively. Results: The average interval between the end of NAC and the examination of MRI was (23±2) d. Interbreeder agreements of T category assignment were highest for T2-weighted TSE BLADE (κ=0.810, P<0.0001). The diagnostic accuracy of T2-weighted TSE BLADE, enhanced StarVIBE and high-resolution StarVIBE delayed scanning for T-staging was 86.1%–96.2%, 86.1%–94.9%, 86.1%–96.2%, respectively. High-resolution StarVIBE delayed scan has the highest value in judging T0, T1, T2 and T4, while T2-weighted TSE BLADE has the highest value in judging T3 lesions. Conclusion: High-resolution delayed phase StarVIBE had the highest diagnostic accuracy in staging EC after NAC for all T categories except T3, for which T2-weighted TSE BLADE had the highest accuracy. Combining all three sequences did not improve diagnostic accuracy.
Keywords: esophageal cancer; T2-weighted turbo spin-echo BLADE; contrast-enhanced StarVIBE; high-resolution delayed phase StarVIBE