基于磁共振高清成像对直肠癌术前肿瘤淋巴结转移(TNM)精准分期的价值研究

Research on the Value of Precise TNM Staging for Rectal Cancer Preoperative Based on High Definition Magnetic Resonance Imaging

目的:分析基于磁共振高清成像对直肠癌术前TNM精准分期的价值。方法:选取某院2021年1月~2023年12月收治的经临床及电子肠镜检查诊断为直肠癌的患者100例为观察对象,术前全部患者均接受磁共振高清成像检查与TNM分期,比较分析术前磁共振高清成像检查结果与术后病理检查结果,探讨磁共振高清成像检查的诊断价值。结果:术后病理分期结果显示,38例患者为T1-T2期,49例患者为T3期,13例患者为T4期;57例患者为N0期,32例患者为N1期,11例患者N2期。动态对比增强磁共振成像(DCE-MRI)检查诊断的T1-T2期准确率为81.58%,T3期准确率为85.71%,T4期准确率为84.62%,T分期的总准确率为84.00%;N0期准确率为80.70%,N1期准确率为75.00%,N2期准确率为72.73%,N分期的总准确率为78.00%。DCE-MRI+弥散加权成像(DWI)检查诊断的T1-T2期准确率为92.11%,T3期准确率为95.92%,T4期准确率为92.31%,T分期的总准确率为94.00%;N0期准确率为94.74%,N1期准确率为87.50%,N2期准确率为81.82%,N分期的总准确率为91.00%。与T3-T4期相比较,T1-T2期的各项DCE-MR参数均明显更低(P<0.05);与N1-N2期相比较,N0期的各项DCE-MR参数均明显更低(P<0.05);DCE-MRI检查、DCE-MRI+DWI检查的Kappa值分别为0.6887、0.6248以及0.8706、0.8347。结论:采用磁共振高清成像检查能对直肠癌患者进行准确的术前TNM分期,与病理分期结果具有比较好的一致性。

Objective:To analyze the value of high definition magnetic resonance imaging in accurate preoperative TNM staging of rectal cancer.Methods:100 patients diagnosed with rectal cancer before surgery through clinical and electronic colonoscopy were selected,all of whom were admitted to a certain hospital from January 2021 to December 2023.All patients underwent high definition magnetic resonance imaging and TNM staging before surgery.The results of preoperative high definition magnetic resonance imaging and postoperative pathological examination were compared and analyzed to explore the diagnostic value of high definition magnetic resonance imaging.Results:The postoperative pathological staging results showed that 38 patients were in T1-T2 stage,49 patients were in T3 stage,and 13 patients were in T4 stage;57 patients were in N0 phase,32 patients were in N1 phase,and 11 patients were in N2 phase.The accuracy of DCE-MRI diagnosis in T1-T2 stage was 81.58%,T3 stage was 85.71%,T4 stage was 84.62%,and the overall accuracy of T stage was 84.00%;The accuracy of N0 stage was 80.70%,N1 stage was 75.00%,N2 stage was 72.73%,and the total accuracy of N stage was 78.00%.The accuracy of DCEMRI+DWI examination for T1-T2 stage diagnosis was 92.11%,T3 stage accuracy was 95.92%,T4 stage accuracy was 92.31%,and the overall accuracy of T staging was 94.00%;The accuracy of N0 stage was 94.74%,N1 stage was 87.50%,N2 stage was 81.82%,and the total accuracy of N stage was 91.00%.Compared with T3-T4 phase,the DCE-MR parameters of T1-T2 phase were significantly lower(P<0.05);Compared with the N1-N2 phase,the DCE-MR parameters in the N0 phase were significantly lower(P<0.05);The Kappa values for DCE-MRI and DCE-MRI+DWI examinations were 0.6887,0.6248,and 0.8706 and 0.8347,respectively.Conclusion:The use of high definition magnetic resonance imaging can accurately stage preoperative TNM in rectal cancer patients,with good consistency with pathological staging results,and has clinical promotion value.