磁共振成像对肾癌术前TNM分期的价值

Role of MRI in determining TNM stage for preoperative renal cell carcinoma

目的评价磁共振成像对肾癌术前TNM分期的诊断价值。方法回顾性分析山东省淄博市中心医院2000年3月～2004年5月收治的36例经手术病理证实的肾癌患者临床和影像学资料。对36例患者术前MRI(均包括T1WI、T2WI及动态增强扫描)表现应用1997年肾癌TNM分期法进行分期。将MRI分期与术后病理分期进行对照,应用Kappa检验评定两者的一致性。结果在T分期及M分期中,MRI分期与手术病理分期有良好的一致性(K值分别为K=0.896,K=0.786)。在判定肾癌并静脉系统受累方面,MRI分期与病理分期有非常高的一致性(K=1)。但N分期两者一致性较差(K=0.367)。结论MRI可用于肾癌术前TNM分期,其对T期、M期及静脉系统受累的评价准确性高,但对N期评价准确性较差。

Objective To probe role of MRI in determining TNM stages for preopera- tive renal carcinoma. Methods 36 patients that had been pathologically proved renal cell carcinoma underwent MRI (including T1WI, T2WI and dynamic-enhanced imaging) before operation. MRI findings were staged according to 1997’ TNM staging for renal tumor. The stages determined by MRI and surgical pathological examination were com- pared using Kappa test so as to detect correlation between them. Results Agreement between MRI staging and surgical-pathologic staging was good for T and M staging (T staging: K = 0.896, M staging: K = 0.786), poor for N staging (K = 0.367), and excellent for the assessment for venous involvement (K = 1). Conclusion MRI is a useful method for preoperative staging of renal cell carcinoma according to the TNM classification. It is good for T and M staging, excellent for venous system involvement, poor for N staging.