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目的探讨3.0 T MR多序列成像评估食管鳞状细胞癌是否侵犯胸主动脉、气管或支气管,以判断肿瘤的可切除性。方法搜集经内镜活检证实的鳞状细胞癌45例,术前均行3.0 T MRI T1WI、脂肪抑制T2WI、动态增强扫描,评价食管鳞状细胞癌与周围结构的解剖关系,并与手术病理结果进行对照。结果 (1)若结合“夹角法”和“三角法”判断胸段食管癌侵犯胸主动脉壁,灵敏度、特异度、准确度高达97.6%、100%、97.8%。用“三角法”判断胸段食管癌侵犯胸主动脉壁,灵敏度、特异度、准确度高达95.2%、100%、95.6%;用“夹角法”判断胸段食管癌侵犯胸主动脉壁,其灵敏度、特异度、准确度分别为100%、0、97.4%。(2)以肿瘤与气管或支气管之间的脂肪间隙消失且其接触长度>3 cm为标准来判断食管癌侵犯气管或支气管,灵敏度、特异度、准确度分别为97.6%、100%、97.8%。结论高场强MR多序列成像有助于判断食管鳞状细胞癌是否侵犯胸主动脉、气管或支气管,以判断肿瘤的可切除性。
Objective To investigate whether 3.0 T MR multi-sequence imaging can assess whether esophageal squamous cell carcinoma infiltrates the thoracic aorta, trachea or bronchus to determine the tumor resectability. Methods Forty-five patients with squamous cell carcinoma confirmed by endoscopic biopsy were enrolled in this study. All patients underwent preoperative 3.0 T MRI T1WI, T2WI and dynamic contrast-enhanced scan to evaluate the anatomic relationship between esophageal squamous cell carcinoma and its surrounding structures. For comparison. Results (1) The sensitivity, specificity and accuracy of thoracic esophageal cancer were 97.6%, 100% and 97.8%, respectively, in combination with the included angle method and trigonometry. With “triangle method” to determine the thoracic esophageal invasion of the thoracic aortic wall, sensitivity, specificity, accuracy as high as 95.2%, 100%, 95.6%; with “angle method” to determine chest thoracic esophageal invasion of chest The aortic wall, its sensitivity, specificity, accuracy were 100%, 0, 97.4%. (2) Sensitivity, specificity and accuracy of esophageal carcinoma were 97.6%, 100% and 97.8%, respectively, with the disappearance of the fat gap between the tumor and the trachea or bronchus and the contact length> 3 cm as the standard. . Conclusion MR imaging of high field intensity can help determine whether esophageal squamous cell carcinoma of the thoracic aorta, trachea or bronchus to determine the resectability of the tumor.