MSCT与MRI在直肠癌诊断及分期中的应用价值

Application Value of MSCT and MRI in the Diagnosis and Staging of Rectal Cancer

目的比较多层螺旋电子计算机断层扫描(Multi-Slice Spiral Computed Tomography,MSCT)和磁共振成像(Magnetic Resonance Imaging,MRI)对直肠癌诊断及分期判断价值。方法选取2017年1月至2021年12月在我院就诊的90例直肠癌患者为研究对象,对患者分别采用MSCT扫描、MRI扫描。以手术病理结果为金标准,分析MSCT与MRI对直肠癌的检出率以及对直肠癌患者术前原发肿瘤(Tumour,T)、淋巴结(Node,N)及远处转移(Metastasis,M)的判断准确率。结果MSCT、MRI对直肠癌的检出率分别为82.22%、85.56%;MSCT诊断T1-2期的灵敏度、特异度、准确度、阳性预测值和阴性预测值,诊断T3期的特异度,诊断T4期的灵敏度、特异度、阳性预测值和阴性预测值,与MRI比较,差异均无统计学意义(P>0.05);MSCT诊断直肠癌T3期的灵敏度、准确度、阳性预测值和阴性预测值,诊断T4期准确度均低于MRI(P<0.05);术前MSCT扫描对N0、N1、N2、M0、M1期诊断的灵敏度、特异度、准确度、阳性预测值和阴性预测值与MRI比较,差异无统计学意义(P>0.05)。两名放射科影像医师对MSCT和MRI诊断直肠癌结果的判断一致性相近。结论MSCT和MRI对直肠癌诊断及术前分期判断具有一定的价值,而MRI对T分期的判断准确率更高。

Objective To compare the value of multi-slice spiral computed tomography(MSCT)and magnetic resonance imaging(MRI)in the diagnosis and staging of rectal cancer.Methods A total of 90 patients with rectal cancer who were admitted to our hospital from January 2017 to December 2021 were selected as the research subjects,and MSCT and MRI scans were performed on the patients respectively.Taking the surgical pathological results as the standard,the detection rate of MSCT and MRI for rectal cancer and the accuracy of judging the preoperative primary tumor(T),lymph node(N)and distant metastasis(M)in patients with rectal cancer were analyzed.Results The detection rates of MSCT and MRI for rectal cancer were 82.22%and 85.56%,respectively.Compared with MRI,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MSCT in diagnosing T1-2 stage,the specificity in diagnosing T3 stage,and the sensitivity,specificity,positive predictive value and negative predictive value in diagnosing T4 stage had no significant difference(P>0.05).The sensitivity,accuracy,positive predictive value and negative predictive value of MSCT in diagnosing T3 stage of rectal cancer,the accuracy of diagnosing T4 stage were lower than those of MRI(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of preoperative MSCT scanning in the diagnosis of N0,N1,N2,M0 and M1 were not significantly different from those of MRI(P>0.05).The two radiologists had similar consistency in the judgment of MSCT and MRI in the diagnosis of rectal cancer.Conclusion MSCT and MRI have certain value in the diagnosis and preoperative staging of rectal cancer,while MRI has a higher accuracy in the judgment of T staging.