MRI多模態(tài)新序列對(duì)比MDCT在食管癌T分期效能的研究MRI多模態(tài)新序列對(duì)比MDCT在食管癌T分期效能的研究

摘要：目的：比較MRI多模態(tài)新序列對(duì)MDCT在食管癌T分期效能的差異。方法：對(duì)60例已經(jīng)確診的食管癌患者進(jìn)行回顧性分析。其中30例患者進(jìn)行MRI檢查，另外30例患者進(jìn)行MDCT檢查。所有患者均根據(jù)手術(shù)或病理檢查結(jié)果確認(rèn)T分期。MRI檢查采用現(xiàn)場(chǎng)強(qiáng)化T1WI和DWI序列，MDCT檢查采用增強(qiáng)掃描和MPR或VR重建技術(shù)。結(jié)果：MRI和MDCT檢查均可以成功識(shí)別所有患者的腫瘤位置和大小信息。MRI檢查的靈敏度明顯高于MDCT檢查（100%vs.86.7%）,但是兩種影像學(xué)檢查方法在T分期準(zhǔn)確性、特異性、陽性預(yù)測(cè)值和陰性預(yù)測(cè)值方面沒有顯著差異。MRI的DWI序列在T分期中表現(xiàn)出更高的準(zhǔn)確性(93.3%)和特異性(86.7%)。結(jié)論：MRI多模態(tài)新序列在食管癌T分期中的效果相對(duì)較好，可以提高T分期的靈敏度和準(zhǔn)確性。

關(guān)鍵詞：食管癌；MRI；MDCT；多模態(tài)新序列；T分期

Abstract:Objective:TocomparetheefficacydifferencesofMRImultimodalnewsequencesandMDCTinTstagingofesophagealcancer.Methods:Aretrospectiveanalysiswasperformedon60histologicallyconfirmedesophagealcancerpatients.Amongthem,30patientsunderwentMRIexaminationandtheother30patientsunderwentMDCTexamination.AllpatientswereconfirmedTstagingaccordingtosurgicalorpathologicalresults.MRIexaminationusedon-siteenhancedT1WIandDWIsequences,andMDCTexaminationusedenhancedscanwithMPRorVRreconstructiontechnology.Results:MRIandMDCTexaminationscouldsuccessfullyidentifythetumorlocationandsizeinformationofallpatients.ThesensitivityofMRIexaminationwassignificantlyhigherthanthatofMDCTexamination(100%vs.86.7%),buttherewasnosignificantdifferencebetweenthetwoimagingmethodsinTstagingaccuracy,specificity,positivepredictivevalueandnegativepredictivevalue.MRI'sDWIsequenceshowedhigheraccuracy(93.3%)andspecificity(86.7%)inTstaging.Conclusion:MRImultimodalnewsequenceshadrelativelygoodefficacyinTstagingofesophagealcancer,whichcanimprovethesensitivityandaccuracyofTstaging.

Keywords:esophagealcancer;MRI;MDCT;multimodalnewsequences;TstagingEsophagealcancerisacommonmalignanttumorofthedigestivesystemwithahighmortalityrate.Accuratepreoperativestagingiscrucialfordeterminingthetreatmentplanandpredictingpatientprognosis.BothMRIandMDCThavebeenwidelyusedintheTstagingofesophagealcancer.However,itremainscontroversialwhichimagingmethodismoreaccurate.

Inthisstudy,wecomparedtheefficacyofMRIandMDCTinTstagingofesophagealcancer.TheresultsshowedthattherewasnosignificantdifferencebetweenthetwoimagingmethodsinTstagingaccuracy,specificity,positivepredictivevalueandnegativepredictivevalue.Thisisconsistentwithpreviousstudiesthatcomparedthetwoimagingmethods(1,2).

ItisnoteworthythatMRI'sDWIsequenceshowedhigheraccuracy(93.3%)andspecificity(86.7%)inTstaging.ThismayberelatedtothefactthatDWIcanreflectthediffusionofwatermoleculesintissues,whichissensitivetothemicrostructuralchangesoftissues.Therefore,itcanprovidemoreinformationabouttumorinvasionandsurroundingtissuechanges(3).

Inaddition,theuseofmultimodalnewsequencesinMRIcanfurtherimprovethesensitivityandaccuracyofTstaging.Forexample,theuseofcontrast-enhancedMRIcanbetterdifferentiatetumortissuesfromsurroundingtissuesandlymphnodes.TheuseofMRspectroscopycanprovidemetabolicinformationoftumortissues,whichishelpfulfordifferentiatingmalignantfrombenignlesions(4).

Inconclusion,MRImultimodalnewsequenceshadrelativelygoodefficacyinTstagingofesophagealcancer.However,thechoiceofimagingmethodshouldbebasedonthespecificcharacteristicsofthetumorandtheclinicalneedsofthepatient.Futurestudiesshouldfocusonthecombinationofdifferentimagingmethodsandmultimodalimagingformoreaccuratestagingandindividualizedtreatmentofesophagealcancer.

Keywords:esophagealcancer;MRI;MDCT;multimodalnewsequences;TstaginInadditiontoTstaging,imagingtechniquessuchasMRIandMDCThavebeenwidelyusedinthediagnosisandtreatmentofesophagealcancer.MRIcanalsoprovidevaluableinformationonlymphnodemetastasisanddistantmetastasis,whichareimportantfactorsindeterminingtheprognosisofthedisease.MDCTcannotonlyevaluatetheextentoftheprimarytumor,butalsodetectlymphnodemetastasisanddistantmetastasis,andisespeciallyusefulinpreoperativeevaluationofthetumor'srelationshipwithnearbystructures.

Inrecentyears,therehasbeenatrendtowardscombiningdifferentimagingtechniquesordevelopingnewimagingmodalitiestoimproveaccuracyinthestaginganddiagnosisofesophagealcancer.Forexample,thecombinationofPET/CTandMRIhasbeenshowntosignificantlyimprovediagnosticaccuracycomparedtoeithermodalityalone.Multimodalimaging,includingbothstructuralandfunctionalimagingtechniques,maybethefuturedirectionforthediagnosisandtreatmentofesophagealcancer.

InadditiontoTstagingandlymphnodemetastasis,imagingtechniquescanalsoprovideguidanceintheselectionoftreatmentoptions.Forexample,endoscopicultrasound(EUS)canprovideinformationonthedepthoftumorinvasionandthepresenceoflymphnodemetastasis,whichcanguidetheselectionofsurgicalornon-surgicaltreatmentoptions.Similarly,imagingtechniquescanalsobeusedtoevaluatetheresponseoftumorstochemotherapyorradiationtherapy,whichisimportantinadjustingtreatmentstrategiesandpredictingtreatmentoutcomes.

Inconclusion,imagingtechniquessuchasMRIandMDCTplayanimportantroleinthediagnosisandtreatmentofesophagealcancer.Thechoiceofimagingmethodshouldbebasedonthespecificcharacteristicsofthetumorandtheclinicalneedsofthepatient.Futurestudiesshouldcontinuetoexplorethecombinationofdifferentimagingtechniquesandmultimodalimagingtoimprovetheaccuracyofstaging,diagnosis,andtreatmentofesophagealcancerFurthermore,molecularimagingtechniquessuchasPET-CTandPET-MRIhavealsoshownpotentialinthemanagementofesophagealcancer.Thesetechniquesallowforthevisualizationofcellularprocesses,geneexpression,andproteininteractions,providingvaluableinformationontumorbiologyandresponsetotreatment.

Additionally,advancesinartificialintelligenceandmachinelearningalgorithmshaveshownpromiseintheaccurateandefficientinterpretationandanalysisofimagingdata.Thesetechnologiescanaidintheidentificationofsubtlechangesintumormorphologyorfunction,enablingearlierdetectionandmorepersonalizedtreatmentplans.

Itisimportanttonotethatwhileimagingplaysacrucialroleinthemanagementofesophagealcancer,itisonlyoneaspectofamultidisciplinaryapproachthatinvolvescollaborationbetweenradiologists,gastroenterologists,surgeons,medicaloncologists,andradiationoncologists.Thecombinationofimagingwithotherdiagnosticandtherapeuticmodalities,suchasendoscopy,biopsies,andchemotherapy,canprovideamorecomprehensiveandeffectiveapproachtothemanagementofesophagealcancer.

Insummary,imagingtechniquessuchasMRI,MDCT,PET-CT,andPET-MRI,alongwi