对比研究CT、MRI对直肠癌术前T、N分期判断的灵敏度、特异度

Comparative study of sensitivity and specificity of CT and MRI in preoperative T and N staging of rectal cancer

目的对比分析CT、MRI对直肠癌术前T、N分期判断的灵敏度及特异度。方法选取2018年2月-2019年2月我院所收治的共70例直肠癌患者影像学资料进行回顾性分析。在实行检查前48h,予以全部病人半流食或流食饮食,于前24h使其饮水1500~2000ml左右,后服用泻药。对全部病人实行全身扫描,选取西门子双源CT(GE Optima 64层)检查扫描CT组病人,选取3.0T Signa HDx MRI系统(GE MEDICAL SYSTEMS)扫描仪扫描检查MRI组病人。完成扫描后向专业工作站进行图像传送,并由影像学医生负责图像分析,观察并判断两种检查方案对直肠癌病人T分期、N分期判断的特异度、灵敏度。结果CT组对直肠癌术前T分期的诊断灵敏度显著低于MRI组,差异具有统计学意义(P<0.05);CT组对直肠癌术前N分期的诊断灵敏度显著低于MRI组,差异具有统计学意义(P<0.05);通过术后病理学检查显示,T1期共25例,T2期29例,T3期16例;N0期30例,N1期21例,N2期19例。结论CT为术前检查必要过程,MRI相较于CT检查,对直肠癌的术前T、N分期诊断符合率较高,但效果仍不显著,存在一定的限制。

Objective The sensitivity and specificity of CT and MRI for preoperative T and N staging of rectal cancer were compared and analyzed.Methods A total of 70 cases of rectal cancer patients admitted to our hospital from February 2018 to February 2019 were selected for retrospective analysis.48 h before the examination,all patients were given semi-liquid food or liquid food diet,and they were allowed to drink about 1500~2000 ml in the first 24 h,and then take laxatives.Perform a whole-body scan on all patients,select Siemens dual-source CT(GE Optima 64-layer)to check and scan patients in the CT group,and select a 3.0 T Signa HDx MRI system(GE MEDICAL SYSTEMS)scanner to scan and check the patients in the MRI group.After the scan is completed,the image is transmitted to a professional workstation,and the imaging doctor is responsible for image analysis,and observes and judges the specificity and sensitivity of the two examination schemes for the judgment of T stage and N stage of rectal cancer patients.Results The sensitivity of CT group to preoperative T staging of rectal cancer was significantly lower than that of MRI group(P<0.05).The sensitivity of CT group to preoperative N staging of rectal cancer was significantly lower than that of MRI group.The difference was significant.(P<0.05);Postoperative pathological examination showed 25 cases in T1,29 cases in T2 stage,16 cases in T3 stage,30 cases in N0 stage,21 cases in N1 stage and 19 cases in N2 stage.Conclusion CT is a necessary procedure for preoperative examination.Compared with CT examination,MRI has a higher coincidence rate for preoperative T and N stage diagnosis of rectal cancer,but the effect is still not significant and there are certain limitations.