MRI联合MSCT检查对结直肠癌术前T、N分期诊断价值研究

Diagnostic Value of MRI Combined with MSCT in Preoperative T and N Staging of Patients with Colorectal Cancer

目的探究MRI检查联合MSCT检查对结直肠癌患者术前T、N分期的诊断价值。方法选取本院2018年6月至2019年3月收治的90例结直肠癌患者。90例结直肠癌患者均经临床确诊为结直肠癌。收集患者临床及影像学资料,总结结直肠癌在MRI检查及MSCT检查中的图像表现,计算两种检查联合对结直肠癌的T分期和N分期的准确率。结果 MRI检查结直肠癌T期的准确率为85.56%,N期的准确率为86.67%;MSCT检查结直肠癌T期的准确率为73.33%,N期的准确率为68.89%,MRI检查显著优于MSCT检查,两者比较差异有统计学差异(P<0.05)。MRI联合MSCT检查结直肠癌T期的准确率为96.67%,N期的准确率为98.89%,二者联合明显高于单一的MRI检查、MSCT检查(P<0.05)。MRI图像显示直肠下段可见溃疡性病变,肠壁近环周增厚。周围直肠系膜脂肪内可见条索影,多发肿大淋巴结,淋巴结形态不规则,信号混杂;子宫后倾,未见明显异常,子宫直肠陷凹内可见少量积液;MSCT图像显示肠壁不规则增厚,肠腔内偏心性分叶状肿块、肠腔狭窄和局部肠壁的异常强化,邻近脏器间脂肪层消失。结论相对于单一MRI或MSCT检查,MRI联合MSCT可有效提高结直肠癌T、N分期的准确率,为临床治疗提供准确影像学资料。

Objective To investigate the diagnostic value of MRI combined with MSCT in preoperative T and N staging of patients with colorectal cancer.Methods 90 patients with colorectal cancer admitted to our hospital from June 2018 to March 2019 were selected.90 patients with colorectal cancer were clinically diagnosed as colorectal cancer.The clinical and imaging data of the patients were collected,and the image performance of colorectal cancer in MRI and MSCT was summarized.The accuracy of MRI combined with MSCT for T and N staging of colorectal cancer was calculated.Results The accuracy rate of MRI for T staging of colorectal cancer was 85.56%,and the accuracy rate for N staging of colorectal cancer was 86.67%.The accuracy rate of MSCT for T staging of colorectal cancer was 73.33%,and the accuracy rate for N staging of colorectal cancer was 68.89%.MRI was significantly better than MSCT,and the difference was statistically significant(P<0.05).The accuracy rate of MRI combined with MSCT for T staging of colorectal cancer was 96.67%,and the accuracy rate for N staging of colorectal cancer was 98.89%.The combination of the two was significantly higher than the MRI and MSCT alone(P<0.05).MRI images showed ulcerative disease in the lower segment of rectum,and the intestinal wall was thickened along the circumference.In the surrounding mesorectal fat,there were visible linear opacities,multiple enlarged lymph nodes with irregular shape,mixed signals,retroversion.No obvious abnormalities were observed,and a small amount of effusion was visible in the rectouterine fossa.MSCT images showed irregular thickening of the intestinal wall,eccentric lobulated mass in the intestinal cavity,intestinal stenosis and abnormal enhancement of the local intestinal wall,and the fat layer between adjacent organs disappeared.Conclusion Compared with MRI or MSCT alone,MRI combined with MSCT can effectively improve the accuracy of diagnosis for T and N staging of colorectal cancer,and provide accurate imaging data for clinical treatment.