在直肠癌患者的MRI上"观察和等待":反应模式及其演变
Aashna Karbhari1, Akshay D Baheti2, Suman K Ankathi1
1Department of Radiology, Tata Memorial Centre and Homi Bhabha National Institute, E. Borges Road, Parel, Mumbai, 400012, India.
Abdominal radiology (New York)
|July 14, 2023
概括
观察和等待 (WW) MRI显示大多数直肠癌患者在治疗后发展稳定纤维化. 最少的纤维化和稳定的痕模式是常见的,表明成功的非手术管理.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
背景情况:
- 结直肠癌的管理越来越多地使用观察和等待 (WW) 方法.
- 通过磁共振成像 (MRI) 准确评估治疗反应对于指导 WW 策略至关重要.
- 了解不断变化的MR模式是区分纤维化与残留疾病的关键.
研究的目的:
- 评估磁共振成像 (MRI) 响应模式及其在使用观察和等待 (WW) 协议管理的直肠癌患者的演变.
- 描述在MRI上观察到的不同类型的治疗后变化.
- 评估这些变化的稳定性,并确定复发的预测因素.
主要方法:
- 从60名接受WW.W.治疗的直肠癌患者中对337名MRI进行了回顾性审查.
- 对瘤特征 (形态,位置,厚度,周围卷入,节点状况,EMVI) 的基线MRI的评估.
- 对治疗后的MRI分析反应模式 (T2,DWI),纤维化演变,痕变化和中位数12个月后续检测复发的分析.
主要成果:
- 确定了五种治疗后的MR模式:正常化壁,最小纤维化,全厚纤维化,不规则纤维化和裂痕.
- 大多数患者 (73%) 在治疗后表现出稳定的纤维化或分裂痕模式.
- 15%的患者经历了瘤再生或复发,与复发相关的特定痕厚度和角度变化标准.
结论:
- 大多数接受WW协议的直肠癌患者会发展到极小或全厚纤维化.
- 这些纤维变化在随访MRI时通常是稳定的.
- 核磁共振是监测反应和检测 WW直肠癌患者的复发有价值的.
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