MRI常规成像序列结合DWI成像序列诊断直肠癌术前TN分期及其与病理的相关性研究

Diagnosis of Preoperative T Stage and N Stage of Rectal Cancer by MRI Conventional Sequence Combined with DWI Sequence and the Correlation with Pathology

目的探究磁共振(MRI)常规成像序列结合弥散加权成像(DWI)序列诊断直肠癌术前TN分期及其与病理的相关性。方法回顾性分析2015年12月-2018年7月于我院肿瘤外科确诊的85例直肠癌患者,均行MRI常规成像序列结合DWI检查,且于检查后2周内接受手术治疗,以肠镜取样病理活检为病理金标准,将MRI常规成像结合DWI检查术前TN分期结果与病理结果进行一致性检验。结果MRI常规成像序列结合DWI成像序列诊断直肠术前T分期与病理一致77例,T1期准确率为92.94%,T2期准确率为96.47%,T3期准确率为94.12%,T4期准确率为97.65%,于T分期的总体准确率为90.59%,Kappa值=0.812,一致性好;MRI常规成像序列结合DWI成像序列诊断直肠术前N分期与病理一致66例,N0期准确率为84.71%,N1期准确率为83.53%,N2a期准确率为92.94%,N2b期准确率为94.12%,于N分期的总体准确率为77.65%,Kappa值=0.553,一致性较好。结论直肠癌患者术前行MRI常规成像序列结合DWI成像检查是一种可信、准确度高的影像学诊断方法,可准确评估术前TN分期,与术后病理比较一致性较高。

Objective To investigate the preoperative T stage and N stage of rectal cancer diagnosed by magnetic resonance imaging(MRI)conventional sequence combined with diffusion-weighted imaging(DWI)sequence and the correlation with pathology.Methods A retrospective analysis was performed on 85 patients with rectal cancer diagnosed in oncological surgery department of the hospital from April 2015 to April 2018.All subjects were examined with MRI conventional sequence combined with DWI,and they were treated by surgery within 2 weeks after the examination.Pathological examination was performed by colonoscopy.The results of conventional MRI combined with DWI for preoperative T stage and N stage and surgical and pathological results were tested for consistency.Results The preoperative T stage diagnosed by MRI conventional sequence combined with DWI sequence was consistent with surgical pathology in 77 cases.The accuracy rates for T1,T2,T3 and T4 stages were 92.94%,96.47%,94.12%and 97.65%,respectively,and the overall accuracy rate for T stage was 90.59%.The Kappa value was 0.812,indicating good consistency.The preoperative N stage diagnosed by MRI conventional sequence combined with DWI sequence was consistent with surgical pathology in 66 cases.The accuracy rates for N0,N1,N2a and N2b were 84.71%,83.53%,92.94%and 94.12%,respectively,and the overall accuracy rate for N stage was 77.65%.The Kappa value was 0.553,indicating good consistency.Conclusion Preoperative MRI conventional sequence combined with DWI is a reliable and accurate imaging diagnosis method for rectal cancer.It can be used to accurately assess the preoperative T stage and N stage,with high consistency with postoperative pathology.