Proton MR Spectroscopyu를 이용한 재발성 직장암과 수술 후 섬유화 현상의 감별

초록

To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in postoperative period, and to evaluate the possibility to discriminate recurrent rectal cancer from postoperative fibrosis by analysis of proton MR spectra. We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in postoperative period after Mile's operation for the resection of rectal cancer. Proton MR spectra of postoperative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P(1.6-4.1ppm)/P(0.9-1.6ppm) in postoperative fibrosis was much higher than that of recurrent rectal cancer with statistical significance(p<.05). Mean of P(1.6-4.1ppm)/P(0.9-1.6ppm) in postoperative fibrosis and recurrent rectal cancer group were 2.71 and 0.29, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from postoperative fibrosis, both the sensitivity and specificity were 100%. Recurrent rectal cancer and postoperative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and 1H-MRS can be a new method for differential diagnosis between recurrent rectal cancer and postoperative fibosis.