磁共振成像在直肠癌术前局部分期中的应用价值

Value of magnetic resonance imaging(MRI) in local staging of colorectal cancer before surgery

目的探讨磁共振成像（MRI）在直肠癌术前TN分期中的应用价值。方法回顾性分析2014年6月-2015年4月经手术病理证实的56例直肠癌患者的MRI影像资料，统计其典型影像学表现，局部组织浸润情况，并与术后病理对照分析。结果直肠癌局部分期中，患者MRI的T分期与病理分期结果的一致性检验Kappa值为0.771，有统计学意义（u=6．341，P〈0．01），T分期的准确度为85．7％（48／56）。MRI对N分期的灵敏度为89．4％（34／38），特异度为88．9％（16／18）。准确度为69．6％（39／56）。其中T4的准确度最高（88．2％），N2的准确度最低（61．5％）。结论MRI对直肠癌术前局部分期有很高的临床价值，T分期准确度较高，对是否有淋巴结转移的灵敏度和特异度尚可，具体分期诊断的准确度略低。

Objective To explore the value of magnetic resonance imaging （MRI） in TN staging of colorectal cancer before surgery. Methods A total of 56 cases of colorectal cancer patients confirmed by surgical pathology from June 2014 to April 2015 were retrospectively analyzed for their MRI data. The typical imaging findings and the local tissue infiltration of the cancer were statistically analyzed and compared to the post-operative pathology of the cancer. Results A- mong the local staging of colorectal cancer, the Kappa value of the consistency test between the T staging by MRI and pathological staging for the patients was 0.771 and with statistical significance （u=6.341, P〈0.01）. The accuracy, of T staging was 85.7%（48/56）. The sensitivity, specificity and accuracy of N staging by MRI were 89.4%（34/38）, 88.9% （16/ 18） and 69.6%（39/56）, respectively. The accuracy of T4 was highest（88.2%） and the accuracy of N2 was lowest （61.5%）. Conclusion MRI is of high clinical value for the local staging of colorectal cancer before surgery. T staging by MRI is of higher accuracy, moderate sensitivity and specificity to determine whether there is lymphatic metastasis and slightly lower accuracy for the staging of tumor.