CT及MRI对直肠癌临床术前分期的诊断价值分析

Diagnostic value and diagnostic accuracy of CT and MRI in preoperative staging of rectal cancer

目的:探究计算机断层扫描(CT)、磁共振成像(MRI)对直肠癌临床术前分期的诊断价值。方法:选取2020年8月—2022年9月于济宁市兖州区人民医院就诊的直肠癌患者80例,且均行CT及MRI检查。以术后病理学检查结果为“金标准”,分析CT、MRI检查在直肠癌术前分期中的诊断价值。结果:CT诊断直肠癌T分期准确率为67.50%,显著低于MRI诊断的91.25%(P<0.01);且MRI诊断直肠癌T1~T2期准确率及T3期灵敏度、特异度、准确率均高于CT检查,诊断T4期灵敏度及准确率均高于CT检查,差异有统计学意义(P<0.05)。CT诊断直肠癌N分期准确率为52.50%,显著低于MRI诊断的77.50%(P<0.01);MRI诊断直肠癌N分期中N0期特异度及准确率均高于CT检查,诊断N1期灵敏度、特异度及准确率均高于CT检查,差异有统计学意义(P<0.05);两种检查在N2期中的诊断效能比较差异无统计学意义(P>0.05)。结论:CT及MRI均可鉴别诊断直肠癌术前分期,但MRI检查诊断准确率较高,可为临床诊疗提供可靠的参考,值得推广应用。

Objective To explore the diagnostic value and diagnostic accuracy of computed tomography(CT)and magnetic resonance imaging(MRI)in preoperative staging of rectal cancer.Methods A total of 80 patients with rectal cancer admitted to Jining City Yanzhou District People's Hospital from August 2020 to September 2022 were selected,and all of them underwent CT and MRI examinations.The diagnostic value of CT and MRI in preoperative staging of rectal cancer was analyzed with the results of postoperative pathology as the"gold standard".Results The accuracy of CT in the diagnosis of T staging of rectal cancer was 67.50%,which was significantly lower than that of MRI(91.25%)(P<0.01).The accuracy of MRI in the diagnosis of rectal cancer at stage T1~T2 and the sensitivity,specificity and accuracy at stage T3 were higher than those of CT,and the sensitivity and accuracy at stage T4 were higher than those of CT,the difference is statistically significant(P<0.05).The accuracy of CT in the diagnosis of N stage of rectal cancer was 52.50%,which was significantly lower than that of MRI(77.50%),with statistical difference(P<0.01).The specificity and accuracy of MRI in the diagnosis of rectal cancer in N stage were higher than those of CT,and the sensitivity,specificity and accuracy of MRI in N1 stage were higher than those of CT,the difference is statistically significant(P<0.05).There was no significant difference in the diagnostic value of the two tests in N2 stage(P>0.05).Conclusion CT and MRI can differentiate the preoperative stage of rectal cancer,but MRI has high diagnostic accuracy,which can provide reliable reference for clinical diagnosis and treatment,and is worthy of popularization and application.