3.0T MRI对直肠癌术前T、N分期及环周切缘受累的诊断价值

Diagnostic value of 3.0T MRI in preoperative TN staging and circumferential resection margin involvement of rectal cancer

目的探讨3.0T MRI对直肠癌行术前T、N分期及环周切缘(CRM)受累评估的准确性。方法回顾性分析2018年7月至2019年7月于本院行手术治疗的62例直肠癌患者的临床资料,患者均经手术病理证实,术前均行MRI检查。以术后病理结果为金标准,将术前MRI T、N分期及环周切缘受累情况与术后病理进行对照,采用Kappa检验分析其与术后病理结果的一致性。结果直肠癌术前MRI T分期与术后病理结果具有较高的一致性(Kappa=0.683,P<0.01);直肠癌术前MRIN分期与术后病理结果一致性较差(Kappa=0.398,P<0.01);直肠癌术前MRI环周切缘评估与术后病理结果有很好的一致性(Kappa=0.801,P<0.01)。结论3.0T MRI对直肠癌术前T分期、环周切缘评估具有较高的准确性,对N分期准确性一般,能为临床治疗方案的选择和预后改善提供帮助。

Objective To investigate the accuracy of preoperative 3.0 T MRI scan to predict tumor stage,lymph node stage and circumferential resection margin(CRM)involvement.Methods Clinical data of 62 patients with rectal cancer who underwent surgical treatment in our hospital from July 2018 to July 2019 were retrospectively analyzed.All patients were confirmed by surgical pathology and underwent MRI examination before surgery.With postoperative pathological results as the gold standard,preoperative MRI TN staging and circumferential marginal involvement were compared with postoperative pathology,and Kappa test was used to analyze their consistency with postoperative pathological results.Results There was high consistency between preoperative MRI T staging and pathological results of rectal cancer(Kappa=0.683,P<0.01).The consistency between preoperative MRI N staging and pathological results of rectal cancer was poor(Kappa=0.398,P<0.01).There was good consistency between the preoperative MRI circumferential margin evaluation and the pathological results of rectal cancer(Kappa=0.801,P<0.01).Conclusion 3.0T MRI has high accuracy in preoperative T stage and peripheral incisal margin evaluation of rectal cancer,and is generally accurate in N stage,which can help to select clinical treatment plan and improve prognosis.