MR小fov T1、T2 FSE序列对直肠癌的诊断应用

MR Small fov T1 and T2 FSE Sequences for the Diagnosis of Rectal Cancer

目的:探究小视野(field of view,fov)磁共振(magnetic resonance,MR)检查在直肠癌T分期中的应用价值。方法:选择2017年1月至2019年12月经肠镜证实为直肠癌的60例患者,分别于其术前实施小fov MR检查,并由影像学医师根据结果判断患者T分期,并勾勒肿瘤边界,计算肿瘤体积,而后以术后直肠癌病理结果为金标准,计算小fov MR对直肠癌不同T分期检测的一致性,并分析小fov MR测算的肿瘤体积与肿瘤T分期的相关性。结果:(1)分析发现,小fov MR对直肠癌T分期的预测同病理T分期结果具有较高的一致性(Kappa=0.812),诊断准确率为85.00%(102/120);(2)进一步分析显示,小fov MR对T1期诊断一致性95.00%,灵敏度为71.43%,特异度为98.11%,T2期诊断一致性为81.67%,灵敏度为90.00%,特异度为65.00%,T3期诊断一致性为83.33%,灵敏度为80.00%,特异度为80.00%,T4期诊断一致性为71.67%,灵敏度为66.67%,特异度为85.22%;(3)相关性分析显示,肿瘤体积与病理T分期之间存在明显的正相关联系(r=0.617,P<0.05)。结论:小fov MR在直肠癌T分期鉴别中具有较好的应用价值,能够应用于患者术后T分期评估和治疗方案的确定上,具有一定的应用前景。

Objective: Investigate the value of small field of small view(fov) magnetic resonance(MR) examination in T staging of rectal cancer. Methods: A total of 60 patients with colon cancer confirmed by colonoscopy from January 2017 to December 2019 were selected, and a small fov MR examination was performed before surgery. The imaging stage was used to determine the T stage of the patient based on the results, and the tumor boundaries were calculated. Tumor volume, and then using postoperative rectal cancer pathological results as the gold standard, calculate the consistency of small fov MR for different T staging of rectal cancer, and analyze the correlation between tumor volume and small T staging calculated by small fov MR. Results:(1) The analysis found that small fov MR’s prediction of rectal cancer T staging was highly consistent with pathological T staging results(Kappa=0.812), and the diagnostic accuracy was85.00 %.(2) The diagnosis consistency of small fov MR for T1 stage was 95.00 %, sensitivity was 71.43 %, specificity was 98.11 %, T2 stage diagnosis was 81.67 %, sensitivity was 90.00 %, specificity was 65.00 %, and T3 stage diagnosis was 83.33 %, sensitivity was80.00 %, specificity was 80.00 %, T4 diagnosis consistency was 71.67 %, sensitivity was 66.67 %, specificity is 85.22 %.(3) Correlation analysis shows that tumor volume and pathological T stage There was a significant positive correlation between them(r=0.617, P<0.05).Conclusion: Small fov MR has a good application value in the identification of T staging of rectal cancer, and can be used in the evaluation of T staging and the determination of treatment options for patients after surgery.