MSCT与MRI检查直肠筋膜图像表现对直肠癌术前T分期及术后复发的预测价值

Imaging Features of Rectal Fascia in MSCT and MRI and Its Predictive Value for Preoperative T Staging and Postoperative Recurrence of Rectal Cancer

目的探讨MSCT与MRI检查直肠筋膜图像表现对直肠癌术前T分期及术后复发的预测价值。方法选取我院2015年7月至2018年7月收治的直肠癌患者88例,收集所有患者的临床资料,检查结果以病理学为标准,比较MSCT与MRI检查直肠筋膜浸润分级的准确诊断率。结果比较MSCT与MRI检查T分期的准确诊断率,MRI对浸润结果的总准确率为92.04%(81/88),对T1-2期患者的诊断准确率为82.35%(14/17),T3期诊断准确率为96.77%(30/31),T4期的诊断准确率为92.50%(37/40);MSCT扫描对浸润结果的总准确率为81.81%(72/88),对T1-2期患者的诊断准确率为70.58%(12/17),T3期诊断准确率为77.41%(24/31),T4期的诊断准确率为90.00%(36/40)。MRI与MSCT对直肠癌的T分期的总诊断准确率比较,差异有统计学意义,MRI的T分期诊断准确率更高(χ^(2)=4.051,P=0.044)。结论对直肠癌筋膜浸润程度采用MSCT、MRI检查进行术前诊断具有较高价值,其中MRI对T分期诊断准确率更高,能为临床治疗方案的制定和判断预后提供更多可靠影像学信息。

Objective To investigate the imaging features of rectal fascia in MSCT and MRI and its predictive value for preoperative T staging and postoperative recurrence of rectal cancer.Methods 88 patients with rectal cancer admitted to our hospital from July 2015 to July 2018 were enrolled.The clinical data of all patients were collected.The pathological examination results were used as the standard to compare the accuracy of MSCT and MRI in the diagnosis of infiltration grading of the rectal fascia.Results To compare the diagnostic accuracy of MSCT and MRI for T-stage,the total accuracy of MRI for infiltration was 92.04%(81/88),the accuracy for stage T1-2 was 82.35%(14/17),the accuracy for stage T3 was 96.77%(30/31),and the diagnostic accuracy for stage T4 was 92.50%(37/40).The total accuracy of MSCT scan for infiltration was 81.81%(72/88),the accuracy for stage T1-2 was 70.58%(12/17),the accuracy for stage T3 was77.41%(24/31),and the diagnostic accuracy for stage T4 was 90.00%(36/40).Compared with the overall diagnostic accuracy of MSCT,MRI was more accurate in T staging(χ^(2)=4.051,P=0.044).Conclusion MSCT and MRI are used to diagnose the degree of mesangial infiltration of rectal cancer before operation,MRI can provide more reliable imaging information for clinical treatment and prognosis.