HR-MRI联合DWI序列在直肠癌术前TN分期中的价值及其与病理的相关性研究

Correlation between HR-MRI combined with DWI sequences in preoperative TN staging and pathology of rectal cancer

目的研究HR-MRI联合DWI序列在直肠癌术前T、N分期中的价值及其与病理的相关性。方法将88例直肠癌患者按照随机数字表法分为试验组44例和对照组44例,对照组患者接受直肠常规MRI检查进行术前分期,而试验组患者接受直肠HR-MRI联合DWI序列检查进行术前分期。收集整理两组患者临床资料,主要包括常规MRI诊断对直肠癌术前T、N分期以及HR-MRI与DWI序列对直肠癌术前T、N分期的准确度、灵敏度、特异度、阳性预测值与阴性预测值。结果对照组T1~4分期的准确度分别为88.63%、79.54%、81.81%、100.00%,N分期的准确度为70.45%,灵敏度为61.04%;试验组T1~4分期的准确度分别为97.72%、90.90%、93.18%、100.00%,N分期的准确度为83.96%,灵敏度为88.78%。试验组对直肠癌术前T、N分期的准确度和灵敏度均优于对照组,差异有统计学意义(P﹤0.05)。结论 HR-MRI与DWI序列可以作为一种直肠癌术前T、N分期的有效方法,安全可靠,可行性高,可以为临床治疗提供更有效的依据。

Objective To study the value of HR-MRI combined with DWI sequence in preoperative T and N staging of rectal cancer and the correlation with pathology. Method 88 cases of patients with rectal cancer were randomized as study group（n=44） and control group（n=44）, the patients in control group were examined with conventional rectal MRI for preoperative staging, and the study group patients received rectal HR-MRI combined with DWI sequence inspection for preoperative staging. Clinical data were collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of conventional MRI and HR-MRI combined with DWI sequence used in preoperative T and N staging were evaluated. Result In the control group, the T1-4staging accuracy is 88.63%, 79.54%, 81.81% and 100.00%,respectively, N staging accuracy was 70.45%, sensitivity was 61.04%; the T1-4staging accuracy of the study group was97.72%, 90.90%, 93.18% and 100.00%, respectively, N staging accuracy was 83.96%, sensitivity was 88.78%. The accuracy and sensitivity of the study group in preoperative T and N staging of rectal cancer were better than those of the control group, the difference was statistically significant（P〈0.05）. Conclusion HR-MRI combined with DWI sequence can be used as an effective method for preoperative T and N staging of rectal cancer. It is safe, reliable and feasible, and can provide a more effective basis for clinical treatment.