MRI、MSCT、TRUS在直肠癌术前分期上的应用研究

Value of MRI,MSCT and TRUS in Preoperative Staging of Rectal Cancer

目的探讨磁共振(MRI)、多层螺旋CT(MSCT)、经直肠超声(TRUS)在直肠癌术前分期评价上的临床应用价值。方法选择经手术治疗的直肠癌患者47例。所有患者在术前联合进行MRI、MSCT、TRUS检查。检查后分别单独依据MRI、MSCT、TRUS以及综合各种影像学方法对直肠癌进行影像学T分期和N分期,并与手术病理分期对照。结果术前MRI、TRUS和MSCT的T分期准确度分别为87.23%(41/47)、76.60%(36/47)和78.72%(37/47),Kappa值分别为0.776、0.600和0.590(P均<0.001);术前MRI、TRUS和MSCT的N分期准确度分别为65.96%(31/47)、59.57%(28/47)和57.45%(27/47),Kappa值分别为0.453、0.361和0.352(P均<0.001)。依据影像学方法综合评价直肠癌T分期和N分期的准确度分别为91.49%(43/47)和72.34%(34/47)。结论 MRI、MSCT、TRUS在直肠癌术前分期上,具有突出的临床应用价值。

Objective To investigate the diagnostic value of magnetic resonance imaging （MRI）, multi-slice spiral computed tomography （MSCT） and transrectal ultrasound （TRUS） in preoperative staging of rectal carcinoma. Method 47 patients with pathologically confirmed rectal carcinoma were detected by both MRI, MSCT and TRUS before surgery. The preoperative T staging and N stage of rectal carcinoma were performed by MRI, MSCT, TRUS respectively or by all of synthetically images. The preoperative staging results were compared with those of postoperative pathological staging. Results The preoperative T staging of rectal carcinoma was 87.23% （kappa=0.776, P〈0.001） by MRI, 76.60% （kappa=0.600, P〈0.001） by TRUS, 78.72% （kappa=0.590, P〈0.001） by MSCT, respectively. The preoperative N staging of rectal carcinoma was 65.96% （kappa=0.453, P〈0.001） by MRI, 59.57% （kappa=0.361, P〈0.001） by TRUS, 57.45% （kappa=0.352, P〈0.001） by MSCT, respectively. The preoperative T staging of rectal carcinoma was 91.49% （P〈0.001） by all of synthetically images. The preoperative N staging of rectal carcinoma was 72.34% （P〈0.001） by all of synthetically images. Conclusion It was useful to appreciate the preoperative staging of rectal carcinoma by MRI, MscT and TRUS.