MRI和多层螺旋CT在直肠癌术前诊断的临床应用价值比较

Comparison of the Clinical Value of MRI and Multi-Slice Spiral CT in Preoperative Diagnosis of Rectal Cancer

为探讨磁共振成像（MRI）和多层螺旋CT在直肠癌术前诊断及分期中的临床应用价值，回顾性分析经手术病理诊断的53例直肠癌患者的临床资料。该组患者术前均经MRI及多层螺旋CT检查，以术后病理学诊断为金标准，比较MRI和多层螺旋CT在术前临床分期中的应用价值。结果显示，MRI对T分期诊断总的准确率为92．5％，显著高于多层螺旋CT的75．5％（P〈0．05）。MRI与多层螺旋CT对T3、T4分期的诊断准确率差异无统计学意义（P〉0．05）。弥散加权成像（DWI）扫描的敏感度及阴性预测值最高，分别为92．3％和88．2％，显著高于MRI与多层螺旋CT（42．3％、57．1%和73．1％、61．1％）（P〈0．05）。结果表明，在直肠癌术前诊断及分期方面，MRI的作用优于多层螺旋CT，对手术方式的选择具有较高的临床参考价值。

In order to explore the clinical value of magnetic resonance imaging（MRI） and multi-slice spiral CT in the preoperative diagnosis and staging of rectal cancer,the clinical data of 53 cases with rectal cancer were analyzed retrospectively who had underwent MRI and multi-slice spiral CT preoperatively and had been pathologically confirmed during surgery. Postoperative pathological diagnosis was used as the gold standard,the preoperative clinical staging value of MRI and multi-slice spiral CT were compared. The re-sults showed that the accuracy rate of MRI was 92.5% for T staging,which was significantly higher than that of multi-slice spiral CT （75.5%, P〈0.05 ）. The accuracy rate of MRI for T3,T4 staging and multi-slice spiral CT for one was not statistically significant （ P 〉 0.05）. The sensitivity and negative predictive value of diffusion weighted imaging （DWI） scans were of the highest,which were 92.3% and 88.2% re- spectively and significantly higher than those of MRI and multi-slice spiral CT （42. 3%, 57. 1% and 73.1%,61.1% ） （ P〈0.05）. It is concluded that MRI is superior to multi-slice spiral CT in preoperative diagnosis and staging for rectal cancer,with a high clinical value to the choice of surgical procedure.