MRI结合腔内充盈耦合剂在直肠癌术前评估中的应用

Application of MRI combined with intraluminal filling with coupling agent in preoperative evaluation of rectal cancer

目的探讨MRI结合腔内充盈耦合剂在直肠癌术前评估中的应用价值。方法选取2021年2月至2023年2月在焦作市人民医院经直肠镜检病理证实的拟行手术治疗的78例直肠癌患者为研究对象,均在术前行直肠MRI检查及腔内充盈耦合剂后MRI检查。以术后病理结果为金标准,评估MRI与MRI结合腔内充盈耦合剂对直肠癌T、N分期的诊断符合率。结果手术病理结果显示,78例直肠癌患者中T1期10例、T2期16例、T3期38例、T4期14例,N0期17例、N1期36例、N2期25例。MRI结合腔内充盈耦合剂诊断出T1期10例、T2期13例、T3期35例、T4期14例,诊断T分期准确率为92.31%。MRI诊断出T1期10例、T2期11例、T3期30例、T4期11例,诊断T分期准确率为79.49%。MRI结合腔内充盈耦合剂诊断T分期准确率高于MRI,差异有统计学意义(P<0.05)。MRI结合腔内充盈耦合剂诊断出N0期16例、N1期31例、N2期21例,诊断N分期准确率为87.18%;MRI诊断出N0期13例、N1期26例、N2期19例,诊断N分期准确率为74.36%,MRI结合腔内充盈耦合剂诊断N分期准确率高于MRI,差异有统计学意义(P<0.05)。结论MRI结合腔内充盈耦合剂可准确对直肠癌患者进行术前分期和评估,为临床诊疗提供帮助。

Objective To investigate the application value of MRI combined with intraluminal filling with coupling agent in preoperative evaluation of rectal cancer.Methods A total of 78 patients with rectal cancer who were confirmed by proctoscopy and pathology and planned to undergo surgical treatment from February 2021 to February 2023 were selected as the study subjects.All patients underwent rectal MRI examination before surgery and after intraluminal filling with coupling agent.Postoperative pathological results were used as the gold standard to evaluate the overall coincidence rates of MRI and MRI combined with intraluminal filling with coupling agent for T and N staging of rectal cancer.Results Surgical and pathological results showed that among the 78 patients with rectal cancer,there were 10 cases in T1 stage,16 cases in T2 stage,38 cases in T3 stage,14 cases in T4 stage,17 cases in NO stage,36 cases in N1 stage,and 25 cases in N2 stage.Compared with surgical and pathological results,MRI combined with intraluminal flling with coupling agent diagnosed 10 cases in T1 stage,13 cases in T2 stage,35 cases in T3 stage and 14 cases in T4 stage,with a diagnostic accuracy rate of 92.31%for T stage.MRI diagnosed 10 cases in T1 stage,11 cases in T2 stage,30 cases in T3 stage,and 11 cases in T4 stage,with a diagnostic accuracy rate of 79.49%for T stage.The accuracy of MRI combined with intraluminal flling with coupling agent for diagnosing T stage was higher than that of MRI(P<0.05).MRI combined with intraluminal flling with coupling agent diagnosed 16 cases in NO stage,31 cases in N1 stage and 21 cases in N2 stage,with a diagnostic accuracy rate of 87.18%for N stage.MRI diagnosed 13 cases in NO stage,26 cases in N1 stage and 19 cases in N2 stage,with a diagnostic accuracy rate of 74.36%for N stage.The accuracy of MRI combined with intraluminal filling with coupling agent for diagnosing N stage was higher than that of MRI(P<0.05).Conclusions MRI combined with intraluminal filling with coupling agent can accurately stage and evaluate rectal cancer before surgery,thus providing reference for clinical diagnosis and treatment.