MR背景抑制DWI与CT对结直肠癌术前淋巴结分期的对比研究

Compared MRI with Diffusion Weighted Imaging with Background Body Signal Suppression with CT:Clinical Value of the Preoperative Lymph Node Staging of Colorectal Cancer

目的:探讨MR背景抑制弥散加权成像对结直肠癌术前淋巴结分期的临床价值及对比研究。方法:59名原发性结直肠癌患者于术前均行CT和MRI检查。将肿瘤分化程度与N分期进行对照,CT和MR的分期结果与病理结果进行对照,并对其进行统计学分析。结果:DWIBS检测淋巴结的敏感性为100%,DWIBS和CT的总体符合率分别为54.2%和69.5%。CT术前N分期与病理N分期相关性尚好,Kappa值为0.387(P<0.05),而普通MRI术前N分期则与病理N分期无明显相关性,Kappa值为0.102(P>0.05)。CT和MRI评估淋巴结边缘的N分期总体符合率分别为59.3%和61%。结论:DWIBS评估结直肠患者的淋巴结转移具有极高的敏感性和阴性预测值,对分期及鉴别诊断有很大帮助,尤其对发现小淋巴结有很大的价值。

Purpose： To investigate the clinical value of MRI with diffusion weighted imaging with background body signal suppression （DWIBS） in the preoperative lymph node staging in patients with colorectal cancer. Methods： Fifty-nine subjects with primary colorectal cancer were preoperatively assessed by CT and MRI. Tumor diagnosis was compared with the final histological nodal staging. Preoperative lymph node staging was compared with the final histological findings. Results： The sensitivity of DWIBS was 100%. The overall accuracy of DWIBS and CT were 54.2%, and 69.5%, respectively. Preoperative CT nodal staging had a fair correlation with pathologic results and the Kappa value was 0.387 （P〈0.05）. No correlation with statistical significant between preoperative MRI nodal staging and pathologic results was found. The Kappa value was 0.102 （P〉0.05）. In terms of evaluation of the border contour of lymph nodes, the overall accuracy of CT and MRI were 59.3%, and 61%, respectively. Conclusion： DWIBS can provide nodal staging and differential diagnosis with high sensitivity and negative predictive value for evaluating primary colorectal cancer patients, and especially it has a great diagnostic value in differentiating small malignant lymph nodes from benign ones.