高分辨MRI成像技术对直肠癌术前T、N分期的病理对照研究

High-resolution MRI Imaging Technology in the Pathology Control Study of T and N Staging of before the Operation of Rectal Cancer

目的分析高分辨磁共振(MRI)成像技术对直肠癌术前T、N分期的病理对照结果。方法选择2018年1月至2019年12月期间于我院肿瘤外科就诊并行手术切除治疗的74例直肠癌患者,所有患者均在术前14d内接受高分辨MRI检查。以手术病理结果为“金标准”,分析高分辨MRI成像诊断术前T、N分期及环周切缘(CRM)阳性的准确率。结果高分辨MRI检查T分期与病理一致59例,15例不一致,于T分期的总体准确率为81.08%,Kappa值为0.728,与病理结果具有较好的一致性;高分辨MRI检查N分期与病理一致52例,22例不一致,于N分期的总体准确率为70.27%,Kappa值为0.546,与病理结果的一致性一般;病理结果CRM阳性31例,高分辨MRI检查为34例,3例受侵者误诊为未受侵,6例未受侵者误诊为受侵,高分辨MRI检查CRM阳性的准确率为87.84%,Kappa值为0.754,与病理结果具有较好的一致性。结论高分辨MRI对直肠癌术前T、N分期及CRM受侵情况的评估与病理结果符合率较高。

Objective To analyze the controlled results of high-resolution magnetic resonance imaging(MRI)technology on T and N staging of before the operation of rectal cancer.Methods A total of 74 patients with rectal cancer treated with surgical resection in the tumor surgery department of our hospital from January 2018 to December 2019 were selected.All patients received high-resolution MRI examination within 14 days before the operation.The surgical pathological results were treated as the gold standard.The accuracy of high-resolution MRI imaging in diagnosising positive T and N staging and circumferential resection margin(CRM)before the operation was analyzed.Results There were 59 cases of T staging examined by high-resolution MRI that were consistent with pathology and 15 cases were inconsistent with it.The overall accuracy rate of T staging was 81.08%,and the Kappa value was 0.728,which was in good consistent with the pathological results;There were 52 cases of N staging examined by high-resolution MRI that were consistent with pathology and 22 cases were inconsistent with it.The overall accuracy rate of N staging was 70.27%,and the Kappa value was 0.546,which was generally consistent with the pathological results;There were 31 cases with positive CRM in pathological results,while there were 34 cases detected by high-resolution MRI,in which 3 cases of invaders were misdiagnosed as uninvaded,and 6 uninvaded patients were misdiagnosed as invaded.The accuracy rate of high-resolution MRI examination of positive CRM was 87.84%,and the Kappa value was 0.754,which was relatively good consistent with the pathological results.Conclusion The high-resolution MRI evaluation of T,N staging and CRM invasion condition before the operation of rectal cancer has a high coincidence rate with pathological results.