直肠内超声检查与磁共振成像对直肠癌术前分期诊断价值的对比

Diagnostic value of ultrasound and MRI in the preoperative staging of rectal cancer

目的:评估直肠内超声检查及磁共振成像(MRI)对直肠癌术前分期的诊断价值。方法:回顾性分析经病理证实的直肠癌患者的术前MRI和超声影像资料,以病理诊断为金标准,对比直肠内超声检查、MRI对直肠癌术前分期的诊断价值。结果:直肠内超声检查对T_1直肠癌的诊断准确率高于MRI,对T_4直肠癌的诊断准确率低于MRI,差异有统计学意义(P<0.05)。MRI对N_0、N_2直肠癌诊断阳性率高于直肠内超声检查,差异有统计学意义(P<0.05);MRI对N_1直肠癌检测的阳性率与超声检查相当。直肠内超声检查术前诊断直肠癌T、N分期准确率的曲线下面积(AUC)小于MRI,但差异无统计学意义。结论:直肠癌不同病理分级需选择不同的检查方法进行评估,疑似高级别直肠癌患者术前分期诊断优先选择MRI,而对于病理分级低者或术后随访可选择直肠内超声检查。

Objective：To evaluate the diagnostic value of ultrasound and MRI in preoperative staging of rectal cancer.Methods：A retrospective analysis of preoperative MRI and ultrasound in patients with pathologically proved rectal cancer was performed.The diagnostic values of ultrasound and MRI in preoperative staging of rectal cancer were compared by using pathological diagnosis as the gold standard.Results：The accuracy of transrectal ultrasound was higher than that of MRI in the diagnosis of T1 rectal cancer,its accuracy was lower than that of MRI in the diagnosis of T4 rectal cancer,and the differences were statistically significant（P〈0.05）.The accuracy of MRI was higher than that of ultrasound in the diagnosis of N0 and N2 rectal cancer,and the differences were statistically significant（P〈0.05）.And the difference between MRI and ultrasound in the diagnosis of N1 rectal cancer was not statistically significant.The area under the curve（AUC）of ultrasound was less than that of MRI in the preoperative diagnosis of rectal cancer,but the difference was not statistically significant.Conclusions：Rectal cancer of different pathological grades should be examined by different methods.MRI should be chosen for suspected advanced rectal cancer patients in preoperative staging diagnosis,and ultrasound should be selected for lower-grade rectal cancer or follow-up process.