MRI和多层螺旋CT在直肠癌术前TN分期中的临床应用

Clinical application of MRI and multi-slice spiral CT in preoperative TN staging of rectal cancer

目的探讨MRI和多层螺旋CT在直肠癌术前TN分期中的临床应用。方法选择2016年2月~2019年2月在我院治疗的直肠癌患者80例为研究对象,术前均进行MRI和多层螺旋CT检查,观察所有患者TN分期情况。结果病理检查中,T1~2为18例,T3为35例,T4为27例;其中MRI检查中T1~2为15例,T3为31例,T4为24例;CT检查中T1~2为10例,T3为23例,T4为18例。MRI检测准确率(87.50%)高于CT(63.75%),差异显著(P<0.05)。MRI检查N分期情况(83.75%)与CT(81.25%)之间并无差异。其中MRI检测敏感度为80.00%[8/(8+2)],特异度为95.71%[67/(3+67)]。CT检测敏感度为57.14%[4/(4+3)],特异度为76.71%[56/(56+17)],MRI敏感度、特异度明显高于CT,差异有统计学意义(P<0.05)。结论MRI和多层螺旋CT均可作为直肠癌术前TN分期可靠检查方式,相比多层螺旋CT,MRI在术前T分期上诊断准确率较高,但在N分期上两种检测方式并无异同,值得应用。

Objective To study the clinical application of MRI and multi-slice spiral CT in the preoperative TN staging of rectal cancer.Methods Eighty patients with rectal cancer treated in our hospital from February 2016 to February 2019 were enrolled in the study.Preoperative MRI and multi-slice spiral CT were performed for all the patients in order to observe the TN staging.Results In pathological examination,there were 18 cases of T1-2,35 cases of T3 and 27 cases of T4.In MRI examination,there were 15 cases of T1-2,31 cases of T3 and 24 cases of T4.In CT examination,there were 10 cases of T1-2,23 cases of T3 and 18 case of T4.The accuracy of MRI detection was 87.50%,which was higher than the 63.75%of CT,with significant difference(P<0.05).There was no difference between the 83.75%of MRI and the 81.25%of CT in N-staging.The sensitivity of MRI detection was 80.00%[8/(8+2)]and the specificity was 95.71%[67/(3+67)].The sensitivity of CT detection was 57.14%[4/(4+3)]and the specificity was 76.71%[56/(56+17)].The sensitivity and specificity of MRI were significantly higher than those of CT,with significant differences(P<0.05).Conclusion Both MRI and multi-slice spiral CT can be used as the reliable examination methods for preoperative TN staging of rectal cancer.Compared with multi-slice spiral CT,MRI has a higher diagnostic accuracy in preoperative T staging,but the two detection methods are not different in N staging,thereby worthy of application.