磁共振成像在综合治疗背景下诊断直肠肿瘤累及的信息价值

D. Ivanova, Marina A. Safonova
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摘要

本研究的目的是在AI“共和肿瘤药房”Cheboksary的基础上,在对患者进行联合治疗(化疗+放疗)的背景下,证明磁共振成像在直肠肿瘤累及诊断中的信息价值。所有患者均在Elekta Synergy线性加速器上进行磁共振成像,包括多叶准直器,集成XVI x射线体积成像系统和iViewGT门户成像系统,Mosaiq信息和控制系统。采用SPSS统计软件包(17.0版)的医学统计学标准方法进行统计处理,计算算术平均值(M)、与一般平均年龄的标准差、均值误差(M),并进行Student’st检验。磁共振成像诊断使得在治疗背景下识别和动态控制肿瘤累及直肠的变化成为可能:肿瘤在直肠不同部位的定位变化,取决于与肛门边缘的距离的定位变化,肿瘤壁厚度的变化,淋巴结大小和数量的变化。评估手术干预后肿瘤的外静脉侵袭(EMVI)、边缘切除边界(CRM)及对周围组织的侵袭。本文探讨了直肠癌的发病率取决于年龄、性别、主诉、肿瘤病史、导致这种病理发展的危险因素,以及加重治疗的伴随疾病的存在。根据这项研究的结果,直肠癌最常见于60-70岁的人群,而男性最容易患这种疾病。根据组织形态学资料,94人患腺癌。根据磁共振成像(MRI)显示,放化疗前后的直肠癌主要发生在直肠下壶腹(放化疗前51例,放化疗后48例),恶性肿瘤27例位于距肛缘21- 30mm,放化疗前MRI显示平均壁厚21.5 mm,放化疗后13.9 mm。根据两次MRI检查结果,平均壁厚差为7.61 mm(33.3%),表明放化疗有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
THE INFORMATIVE VALUE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF RECTAL TUMOR INVOLVEMENT AGAINST THE BACKGROUND OF COMBINED TREATMENT
The aim of the study is to prove the informative value of magnetic resonance imaging in the diagnosis of rectal tumor involvement against the background of combined treatment for the patients (chemotherapy + radiation therapy) on the basis of the AI "Republican Oncological Dispensary", Cheboksary. All patients underwent magnetic resonance imaging on Elekta Synergy linear accelerator with a multi-leaf collimator, an integrated XVI X-ray volumetric imaging system and iViewGT portal imaging system, Mosaiq information and control system. Statistical processing was performed using standard methods of medical statistics using the SPSS Statistics package (version 17.0), arithmetic mean (M), standard deviation from the general mean age, mean value errors (m), Student's t-test were also calculated. Magnetic resonance imaging diagnostics made it possible to identify and dynamically control the change in the tumor involvement of the rectum against the background of the treatment: a change in the localization of the tumor in different parts of the rectum, a change in localization depending on the distance from the anal margin, a change in the thickness of the tumor wall, a change in the size and number of lymph nodes. Extramural venous invasion (EMVI), marginal resection boundary (CRM) of the tumor and invasion into surrounding tissues after surgical intervention were evaluated. This article examines the incidence of rectal cancer depending on age, gender, complaints, oncological history, risk factors contributing to the development of this pathology, as well as the presence of concomitant diseases that aggravate treatment. According to the results of the study, rectal cancer is revealed to be most often found in people aged 60–70, while men are most susceptible to the disease. According to histomorphological data, adenocarcinoma prevailed in 94 persons. Rectal cancer before and after chemoradiotherapy, according to magnetic resonance imaging (MRI) findings, prevailed in the rectal lower ampulla (before chemoradiotherapy – in 51 persons, after chemoradiotherapy – in 48), while the malignant neoplasm was at the distance of 21-30 mm from the anal margin in 27 persons, with the average wall thickness of 21.5 mm according to MRI findings before chemoradiotherapy and 13.9 mm after chemoradiotherapy. The difference in the average wall thickness according to the findings of two MRI studies was 7.61 mm (33.3%), which indicates the effectiveness of chemoradiotherapy.
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