内镜超声与核磁共振三维重建对直肠癌术前分期评估比较

Comparative study on endorectal ultrasonography vs. three-dimensional reconstruction magnetic resonance in preoperative staging of rectal cancer

目的通过与术后病理分期对照，比较直肠腔内超声（ERUS）与核磁共振（MR）三维重建对直肠癌术前分期的价值。方法对108例确诊为直肠癌的患者术前行TRUS及盆腔MR三维重建检查，确立内镜超声、MR三维重建的T分期和N分期，并与术后病理分期比较。结果ERUS判断直肠癌T分期和N分期的总准确率分别为85．2％（92／108）、61．1％（66／108）；MR三维重建判断T分期和N分期的总准确率分别为73．1％（73／108）、64．8％（70／108）。ERUS判断直肠癌T分期准确度高于MR三维重建（P〈0．05），评估N分期两者准确率均较低，差异无统计学意义（P〉0．05）。结论ERUS对于直肠癌T分期有较高的诊断准确性，有助于制定合理的治疗方案。

Objective To compare the value of endorectal ultrasonography （ERUS） vs. three-di- mensional reconstruction Magnatic Resonance （MR） in preoperative staging of rectal carcinoma. Methods Both TRUS and three-dimensional reconstruction MR were performed prior to surgery in 108 patients with rectal carcinoma. The T staging and N staging of patients was evaluated and compared with the postoperative pathologic findings. Results The accuracy of TRUS for T staging and N staging was 85.2% （92/108） and 61.1 （66/108） , respectively, while the accuracy of three-dimensional reconstruction MR was 73.1% （73/108） and 64. 8% （70/108）. TRUS was superior to three-dimensional reconstruction MR for judging the tumor invasive depth. Neither was able to provide satisfaction assessment for lymph node metastases. Conclusion ERUS is proved to have a high degree of diagnostic accuracy for T stage of rectal carcinoma.