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1、消化道占位病变低场MR诊断LowfieldMRdiagnosisofthedigestiveductinoccupyinglesion宫长水高颖王静高秀双李润华GONGChang-shuiGAOYingWANGJingGAOXlU-shuangLIYun-hua天津市静海县人民医院MR室(中国301600)MRSection,JingHaiPeople'sHospital,Tianjin,Jinghai,P.R.(China301600)中图分类号：R735文献标识码：A文章编号：1818-0086(2009)02摘要：目的探讨低场磁共振成像对消化道占位病变的诊断价值。方法回
2、顾性分析经手术病理证实49例消化道占位病变MRI表现，行常规轴位、冠状位、矢状位SE/T1WI,FSE/T2WI及轴位脂肪抑制(STIR)扫描。结果食道癌3例，胃癌17例(误诊1例，其中3例肝转移、胃外侵犯1例、1例胸椎转移)，小肠恶性肿瘤5例(误诊1例)，小肠不全梗阻2例，阑尾周围脓肿2例，结肠癌8例，直肠癌11例(精囊腺受侵1例、盆腔淋巴结肿大1例、术后复发4例),肠套叠1例。定位诊断准确率97.76%，定性诊断准确率95.92%o结论低场MRI能充分显示病变部位、形态、周围受侵、淋巴结肿大以及远处转移。磁共振检查对消化道占位病变具有较高的诊断价值。关键词：消化道；占位病
3、变；低场；磁共振成像Abstract:ObjectiveToevaluatethediagnosticvalueoflowfieldmagneticresonanceimaging(MRI)ofthedigestiveductinoccupyinglesion.MethodsTheMRfindingsof49caseswithoccupyinglesionofdigestiveductprovedsurgicallyandpathologicallywereanalyzedretrospectively.ScanSequence:Axial,Coronal,Sagittalp
4、osition:SE/T1WI,FSE/T2WIandAxialpositionSTIR・Results3casesofesophaguscarcinoma;17casesofcancerofthestomach(misdiagnosis:1case,3casesofhepaticmetastasis,Icaseofthoracspinalmetastasis,cancerinvasionoutofstomathinonepatient)・5casesofmalignanttumorinsmallbowels(misdiagnosis:1case)・2cascsofincom
5、pleteileusinsmallbowls,2casesofperiappendicealabscess;8casesofthecoloncarcinoma;11casesoftherectalcarcinoma(toseminalvesicleinonepatient,pelviclymphnodeenlargementwasseeninonepatient.Operatedrecurrencein4patients).1caseoftheintussuseption.TheMRdiagnosticaccuracyofthedigestivetumorlocationwa
6、s97.76%,andtheaccuracyforevaluatingthecausesofthedigestivetumorwas95.92%・ConelusionThelowfieldmagneticresonancecanshowthepostion,shape,invasion,enlargementoflymphnodeandbeyondmetastasisturno匚TheMRimagingishelpfulforthediagnosisofoccupyinglesioninthedigestiveduct.Keywords:Occupyinglesion;Dig
7、estiveduct;Lowficld;MRI消化道肿瘤为常见病、多发病，常伴消化道梗阻，以往检查靠平片、领剂造影、B超，定位、定性诊断率较低，内窥镜对食道、胃、结肠非梗阻性病变诊断较容易，对梗阻性病变可获得病理上的诊断，但对病变范围、管腔外情况就不得而知。以上检查均有其局限性。近年来，随着MR软、硬件技术的发展，如心电门控、呼吸门控及快速扫描序列的研发成功，对消化道病变检查成为现实，尤其是消化道占位性病变，MRI可以全面评价其病变的大小、形态、范围、有无周围侵犯及淋巴结肿大等情况，为临床确定治疗方案提
