平衡稳态自由进动序列MRI评估直肠癌周围良、恶性淋巴结

Balanced steady-state free precession MRI for judging benign and malignant peripheral lymph nodes around rectal cancer

目的观察平衡稳态自由进动(bSSFP)序列MRI评估直肠癌周围良、恶性淋巴结的价值。方法回顾性分析41例直肠癌患者,共于病灶周围检出73枚周围淋巴结,术后病理显示其中恶性37枚、良性36枚;基于T2WI及bSSFP图像评估淋巴结性质,观察其皮质信号及皮髓质分界;以病理结果为金标准,评估bSSFP判断直肠癌周围良、恶性淋巴结的效能。结果基于T2WI评估直肠癌周围良、恶性淋巴结的准确率65.75%,敏感度59.46%,特异度72.22%,阳性预测值68.75%,阴性预测值63.41%,与病理结果的一致性一般(Kappa=0.316)。bSSFP MRI评估直肠癌周围良、恶性淋巴结的准确率78.08%,敏感度72.97%,特异度83.33%,阳性预测值81.82%,阴性预测值75.00%,与病理结果具有中等一致性(Kappa=0.562)。结论bSSFP MRI有助于判断直肠癌周围良、恶性淋巴结。

Objective To explore the value of balanced steady-state free precession(bSSFP)MRI for judging benign and malignant peripheral lymph nodes around rectal cancer.Methods A total of 73 lymph nodes around lesions were detected in 41 patients with rectal cancer,including 37 malignant nodes and 36 benign nodes according to pathology after surgical operation.The nature of lymph nodes were judged based on T2WI and bSSFP images,respectively,and the cortical signals and corticomedullary boundaries of lymph nodes were observed.Taken pathological results as golden standards,the efficacy of bSSFP for judging benign and malignant peripheral lymph nodes around rectal cancer was analyzed.Results The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of T2WI for judging benign and malignant peripheral lymph nodes around rectal cancer was 65.75%,59.46%,72.22%,68.75%and 63.41%,respectively,and its consistency with pathological results was general(Kappa=0.316).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of bSSFP MRI for judging benign and malignant peripheral lymph nodes around rectal cancer was 78.08%,72.97%,83.33%,81.82%and 75.00%,respectively,with moderate consistency to pathological results(Kappa=0.562).Conclusion bSSFP MRI was helpful to judging benign and malignant peripheral lymph nodes around rectal cancer.