正电子发射计算机断层扫描联合磁共振成像对直肠癌淋巴结转移的诊断价值

Diagnostic value of positron emission tomography-computed tomography combined with magnetic resonance imaging in lymph node metastasis of rectal cancer

目的探讨正电子发射计算机断层扫描(PET-CT)联合MRI对直肠癌淋巴结转移的诊断价值。方法回顾性分析2019年1月至2022年1月江西省人民医院/南昌医学院第一附属医院收治的80例直肠癌淋巴结转移患者的临床资料,以病理检查结果为金标准,根据淋巴结是否转移分为观察组(淋巴结转移)及对照组(非淋巴结转移),每组40 例。两组术前均接受PET-CT及MRI检查,比较两组PET-CT、MRI、PET-CT联合MRI检查结果,分析PET-CT、MRI、PET-CT联合MRI与病理检查结果的一致性及诊断直肠癌淋巴结转移的价值。结果观察组PET-CT的SUVmax、SUVmin及平均值均高于对照组,MRI的ADCstandard、ADCslow、ADCfast均低于对照组,PET-CT联合MRI检查的长径、短径均长于对照组,差异有统计学意义(P<0.05)。PET-CT、MRI、PET-CT 联合MRI 与病理检查结果的一致性分别为82.50%、77.50%及97.50%。PETCT、MRI、PET-CT联合MRI检查的灵敏度、准确度比较差异有统计学意义(P<0.05);PET-CT联合MRI检查的灵敏度、准确度均高于MRI单独检查,差异有统计学意义(P<0.05),其余两两比较差异无统计学意义。结论PET-CT联合MRI检查在直肠癌淋巴结转移中诊断价值较高,值得临床推广应用。

Objective To explore the diagnostic value of positron emission tomography-computed tomography(PET-CT)combined with MRI in lymph node metastasis of rectal cancer.Methods The clinical data of 80 cases of rectal cancer with lymph node metastasis admitted to Jiangxi Provincial People's Hospital/the First Affiliated Hospital of Nanchang Medical College from January 2019 to January 2022 were analyzed retrospectively,took the pathological examination results as the gold standard,all patients were divided into the observation group(lymph node metastasis)and the control group(non-lymph node metastasis)according to whether lymph node metastasis occurs,with 40 cases in each group.The two groups underwent preoperative PET-CT and MRI examinations,the results of PET-CT,MRI and PET-CT combined with MRI were compared be-tween the two groups,the consistency between PET-CT,MRI,PET-CT combined with MRI and pathological examination results and the value of diagnosing lymph node metastasis of rectal cancer were analysed.Results The SUVmax,SUVmin and average values of PET-CT examination in the ob-servation group were higher than those in the control group,the ADCstandard,ADCslow and ADCfast of MRI examination were lower than those in the con-trol group,and the long and short diameters of PET-CT combined with MRI examination were longer than those in the control group,the differences were statistically significant(P<0.05).The coincidence of PET-CT,MRI and PET-CT combined MRI with surgical and pathological results was 82.50%,77.50%and 97.50%,respectively.There were significant differences in sensitivity and accuracy among PET-CT,MRI and PET-CT com-bined with MRI(P<0.05);the sensitivity and accuracy of PET-CT combined with MRI were higher than those of MRI,the differences were statisti-cally significant(P<0.05),there was no significant difference between the other pairwise comparisons.Conclusion The clinical value of PET-CT combined with MRI examination has high diagnostic value in the diagnosis of lymph node metastasis of rectal cancer,which is worthy of clinical ap-plication and promotion.