MRI对直肠癌术前分期的评价研究

Evaluation of the preoperative staging of rectal cancer by MRI

目的 探讨盆腔MRI对直肠癌术前分期的价值。方法 5 0例疑诊直肠肿瘤的患者行盆腔MRI扫描,47例经结肠镜或手术病理证实为直肠癌,其中40例有手术、MRI等完整资料参与分期研究,将影像诊断结果与手术病理结果进行对照。结果 MRI对直肠癌诊断的准确率为95 7% (4 5 / 47)。MRI对判断T分期总的准确率为82 5 % (3 3 / 40 ) ,T1～2 期的准确率为69 2 % (9/ 13 ) ,T3 期的准确率为90 0 % (18/ 2 0 ) ,T4期的准确率为85 7% (6/ 7) ,评价肿瘤浆膜外侵犯的准确性为92 6% (2 5 / 2 7)。MRI对盆腔淋巴结转移的诊断准确率为63 2 % (12 / 19)。结论 盆腔MRI对直肠癌的诊断和术前分期有较高的准确性,有助于判断肿瘤浆膜外浸润及区域淋巴结转移。

Objective To evaluate the value of pelvic MRI in the preoperative staging of rectal cancer. Methods Fifty patients suspicious of having rectal cancer underwent pelvic MRI scans after cleansing enema. Forty-seven of 50 patients were proved to have rectal cancer by colonoscopy and/or pathological examination. The MRI findings of 40 patients underwent surgical intervention were compared with the pathological examination for staging. Results The diagnostic accuracy rate of rectal cancer was 95.7% (45/47) by MRI. The overall accuracy rate of T-staging was 82.5% (33/40) by MRI, including T1-2-staging 69.2% (9/13), T3-staging 90.0% (18/20) and T4-staging 85.7% (6/7). The accuracy rate for serosal infiltration was 92.6% (25/27), and 63.2% (12/19) for lymph node involvement. Conclusion Pelvic MRI showed high accuracy for the diagnosis and preoperative staging of rectal cancer, and was useful to detect the serosal infiltration and lymph node metastasis.