磁共振高分辨扫描对直肠癌术前分期的应用价值

Application of High Resolution Magnetic Resonance Imaging in Preoperative Staging of Rectal Cancer

目的探讨磁共振高分辨扫描对直肠癌术前分期的应用价值。方法分析经手术病理确诊的45例直肠癌的MRI图像,术前行MRI常规扫描(T1WI、T2WI、HR-T2WI、DWI及增强扫描)及高分辨T2WI(high revolution T2 weighted imaging,HR-T2WI)扫描,两位经验丰富的腹部MRI诊断医生分别对MRI T1WI、T2WI、HR-T2WI、DWI及增强扫描(常规组)、常规MRI扫描联合HR-T2WI扫描(常规联合HR-T2WI组)进行独立阅片,观察并记录原发肿瘤(T分期)及区域淋巴结转移(N分期),并与术后病理T、N分期结果比较,采用Kappa分析比较两位阅片者在两组图像T、N分期诊断的一致性。结果两位阅片者对常规联合HR-T2WI组、常规组的T、N分期诊断一致性良好,后者高于前者;常规联合HR-T2WI组T分期优于常规组,存在统计学意义(P<0.05),N分期结果比较无统计学意义(P>0.05)。结论磁共振高分辨扫描能够提高直肠癌术前分期尤其是T分期的准确性。

Objective To explore the application value of high-resolution magnetic resonance imaging(MRI)in preoperative staging of rectal cancer,improve the accuracy of MRI in preoperative staging of rectal cancer,and provide more accurate information for surgical operations.Methods The MRI images of 45 cases of rectal cancer confirmed by surgery and pathology were analyzed.Before surgery,routine MRI scans(T1WI,T2WI,HR-T2WI,DWI,and enhanced scans)and high resolution T2 weighted imaging(HR-T2WI)scans were performed.Two experienced abdominal MRI diagnostic medical students underwent MRI T1WI,T2WI,HR-T2WI,DWI,and enhanced scans(conventional group),respectively Routine MRI scanning combined with HR-T2WI scanning(routine combined with HR-T2WI group)was used to independently review the film,observe and record the primary tumor(T stage)and regional lymph node metastasis(N stage),and compared with the postoperative pathological T and N stages.Kappa analysis was used to compare the consistency of the 2 reviewers in the T and N stages of the images in the 2 groups.Chi-square test was used for comparison between the groups,and P<0.05 was statistically significant.Results The consistency of T and N staging diagnosis between the two reviewers in the conventional HR-T2WI group and the conventional group was good,with the former being higher than the latter;Compared between groups,the T stage in the conventional combined HR-T2WI group was superior to the conventional group,with statistically significant results(P<0.05),while the N stage results were not statistically significant(P>0.05).Conclusion High resolution magnetic resonance imaging can improve the accuracy of preoperative staging,especially T staging,of rectal cancer.