직장암의 수술 전 영상의학적 병기 진단 (Preoperative Radiological Staging of Rectal Cancer)

서지정보

· 발행기관 : 대한의사협회
· 수록지 정보 : 대한의사협회지 / 52권 / 5호 / 509 ~ 516페이지
· 저자명 : 김민주

초록

Rectal cancer is a common malignant disease that continues to have a highly variable
outcome, with local recurrence after surgical resection usually leading to an incurable
disease. Local recurrence is dependent upon tumor stages and surgical techniques. There is no
general consensus on the role of transrectal ultrasonography (TRUS), computed tomography
(CT), and magnetic resonance imaging (MRI) in staging of rectal cancer. The role of preoperative
imaging is to determine which therapy may be suitable for the patients by surgery alone or with
additional treatment. Although the tumor stage is an important prognostic factor, the evaluation of
the involvement of the mesorectal fat and mesorectal fascia is even more important. New
developments in techniques such as coils, sequences, and gradients in MRI, and evolution of
multidetector CT (MDCT) allow better diagnostic options for patients with rectal cancer. Highresolution
MRI has proved useful in clarifying the relationship between the tumor and the
mesorectal fascia, representing circumferential resection margin at total mesorectal excision. At
present, MRI is superior to CT or TRUS for assessing the local staging of rectal cancers.
However, nodal staging remains a difficult radiological diagnosis. The role of MDCT has to be
set, but for distant metastatic disease it remains to be the first option. This review discusses on
the current role of the various imaging modalities in preoperative staging of the rectal cancer.

영어초록

Rectal cancer is a common malignant disease that continues to have a highly variable
outcome, with local recurrence after surgical resection usually leading to an incurable
disease. Local recurrence is dependent upon tumor stages and surgical techniques. There is no
general consensus on the role of transrectal ultrasonography (TRUS), computed tomography
(CT), and magnetic resonance imaging (MRI) in staging of rectal cancer. The role of preoperative
imaging is to determine which therapy may be suitable for the patients by surgery alone or with
additional treatment. Although the tumor stage is an important prognostic factor, the evaluation of
the involvement of the mesorectal fat and mesorectal fascia is even more important. New
developments in techniques such as coils, sequences, and gradients in MRI, and evolution of
multidetector CT (MDCT) allow better diagnostic options for patients with rectal cancer. Highresolution
MRI has proved useful in clarifying the relationship between the tumor and the
mesorectal fascia, representing circumferential resection margin at total mesorectal excision. At
present, MRI is superior to CT or TRUS for assessing the local staging of rectal cancers.
However, nodal staging remains a difficult radiological diagnosis. The role of MDCT has to be
set, but for distant metastatic disease it remains to be the first option. This review discusses on
the current role of the various imaging modalities in preoperative staging of the rectal cancer.

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