直接法与助显剂充盈法经直肠超声对直肠癌浸润深度的诊断价值

The diagnostic value of invasion depth of rectal cancer by transrectal ultrasonography with direct and co-agent filling method

目的:探讨360°环阵探头比较直接法及助显剂充盈法经直肠超声(transrectal ultrasonography,TRUS)对直肠癌浸润深度诊断准确性的差异。方法:对67例原发性直肠癌患者术前行TRUS检查,先后使用直接法及助显剂充盈法,判断直肠癌的浸润深度,并与病理结果进行对照,使用Kappa检验评估两者结果的一致性。结果:直接法及助显剂充盈法TRUS评估直肠癌浸润深度总准确率分别为91. 0%和92. 5%。两种方法与病理结果的一致性均较高,但后者(Kappa=0. 846,P=0. 000)明显高于前者(Kappa=0. 685,P=0. 000)。两种方法评估T_1及T_2期直肠癌的准确率分别为89. 2%、95. 6%及90. 4%、93. 7%。助显剂充盈法对T_1及T_2期直肠癌的诊断准确率明显高于直接法。结论:助显剂充盈法TRUS对直肠癌浸润深度的诊断准确率高于直接法,并且T_1及T_2期的应用价值更高。

Objective:To explore the difference of diagnostic accuracy of direct method and co-agent filling method in tumor invasion depth(T-staging)of rectal cancer by 360°transrectal ultrasonography(TRUS).Methods:67 patients with rectal cancer underwent TRUS before surgery to predict T-staging.The results were compared with the postoperative pathological results.Their consistency was evaluated by Kappa test.Results:The total accuracy rate of direct method and co-agent filling method of TRUS in T-staging of rectal cancer were 91.0%and 92.5%.The ultrasound result of two kinds of methods was highly consistent with the pathological result,but the latter(Kappa=0.846,P=0.000)was obviously higher than the former(Kappa=0.685,P=0.000).The diagnostic accuracy of T 1 and T 2 stage of rectal cancer evaluated by two kinds of methods were 89.2%,95.6%and 90.4%,93.7%.The diagnostic accuracy of T 1 and T 2 stage of rectal cancer of co-agent filling method was obviously higher than direct method.Conclusion:The diagnostic accuracy of tumor invasion depth of rectal cancer by co-agent filling method TRUS is higher than direct method,meanwhile,there are higher application value for T 1 and T 2 stage.