高分辨率磁共振成像在直肠癌诊断与术前T分期中的应用价值

Application value of high-resolution magnetic resonance imaging in the diagnosis and preoperative T staging of rectal cancer

目的探讨高分辨率磁共振成像(MRI)在直肠癌诊断与术前T分期的应用。方法选择直肠癌患者68例,均进行3. 0 T MRI检查,以术后病理结果作为标准,分析3. 0 T高分辨MRI对直肠癌诊断的信效度及与病理结果相关性。结果68例患者MRI图像可见偏心性软组织肿块影或不规则环状增厚肿物影,T_1WI呈稍低信号,T_2WI呈不均匀高信号。病理结果显示T_1、T_2、T_3、T_4期分别为3、19、32、14例,高分辨MRI检查结果显示T_1、T_2、T_3、T_4期分别为7、17、31、13例。高分辨MRI对直肠癌术前T分期诊断总准确度为86. 76%,与病理结果诊断一致性较好(Kappa值0. 793)。结论高分辨率MRI对直肠癌诊断准确性较高,是判断术前T分期的重要方法。

Objective To explore the application of high-resolution magnetic resonance imaging （MRI） in the diagnosis and preoperative T staging of rectal cancer. Methods Totally 68 patients with rectal cancer were selected and conducted with 3.0 T MRI. Taking postoperative pathological results as the standard, the reliability and validity of 3.0 T high-resolution MRI and its correlation with pathological findings were analyzed. Results The MRI images of 68 patients showed shadows of eccentric soft- tissue masses or irregular annular thickening masses, with a slightly low signal for T 1WI, and heterogeneous high signal for T 2WI. Pathological results showed there were 3 cases of T 1 stage, 19 cases of T 2 stage, 32 cases of T 3 stage and 14 cases of T 4 stage, and high-resolution MRI results showed that there were 7 cases of T 1 stage, 17 cases of T 2 stage, 31 cases of T 3 stage and 13 cases of T 4 stage. The total accuracy of high-resolution MRI was 86.76% in the diagnosis of preoperative T staging of rectal cancer, which was consistent with the pathological diagnosis （ Kappa value 0.793） . Conclusion High-resolution MRI has a high diagnostic accuracy for rectal cancer, and is an important method for determining preoperative T staging.