高分辨T2WI在直肠癌壁外血管侵犯诊断中的应用价值

Application value of high-resolution MRI T2WI in extramural vascular invasion of rectal cancer

目的:探讨MRI高分辨T2WI在直肠癌壁外血管侵犯(EMVI)诊断中的应用价值。方法:收集49例经肠镜诊断为直肠癌的患者,术前2周内均行高分辨T2WI检查。以病理为金标准,采用Kappa一致性分析评价高分辨T2WI的诊断效能,并绘制ROC曲线评价其诊断价值。结果:EMVI阳性与肿瘤分化程度、T分期、环周切缘相关(均P<0.05)。高分辨T2WI诊断EMVI的敏感度、特异度、阳性预测值、阴性预测值分别为85.71%、85.71%、70.58%、93.75%,与病理诊断的一致性好(K=0.671,P<0.001)。高分辨T2WI诊断的AUC为0.818,标准误为6.2%,95%置信区间(69.6%,93.9%),差异有统计学意义(P<0.05)。结论:高分辨T2WI能够术前准确评价直肠癌EMVI,为术前评估提供重要参考价值。

Objective:To explore the value of high-resolution MRI T2WI sequence in diagnosic of extramural vascular invasion(EMVI)of rectal cancer.Methods:49 cases of rectal cancer were diagnosed by enteroscopy preoperatively,and high-resolution T2WI examine were performed within 2 weeks before surgery.The pathology was the gold standard after operation.Consistency analysis using Kappa to evaluate the diagnostic efficacy between high-resolution T2WI examination and pathology.And ROC curve was drawn to evaluate its diagnostic value.Results:Positive EMVI was associated with the degree of tumor differentiation,T stage and circumferential resection margin(CRM)(all P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of high-resolution T2WI examination and diagnosis of EMVI were 85.71%,85.71%,70.58%and 93.75%,which were accordance from the consistency of pathological diagnosis(K=0.671,P<0.001).The AUC of high-resolution T2WI diagnosis was 0.818,the standard error was 6.2%,the 95%CI was(69.6%,93.9%),which was statistically significant(P<0.05).Conclusion:The high-resolution T2WI scan can accurately evaluate the extramural vascular invasion due to the rectal cancer before surgery,and provide important reference value for preoperative evaluation.