腔内对比剂高分辨率MRI对直肠癌诊断价值研究

The Diagnostic Value of High Resolution MRI for Rectal Cancer After Intracavitary Contrast Medium Injection

目的比较直肠腔内对比剂注入前、后高分辨率MRI(HR-MRI)图像质量及其对直肠癌T分期的诊断价值。方法搜集本院2016年2月至2017年5月经手术病理证实的直肠癌患者54例,所有患者术前均接受腔内对比剂注入前、后HR-MRI扫描。比较腔内对比剂注入前、后两组HR-MRI图像质量,并应用HR-MRI对两组图像进行T分期,进一步与术后病理结果比较。结果腔内对比剂注入前、后HR-MRI图像质量良好率分别为81.48%(44/54)、94.44%(51/54);两组图像质量等级比较差异具有统计学意义(P<0.05)。54例患者中,pT1期8例,pT2期17例,pT3期25例,pT4期4例。以病理结果为标准,腔内对比剂注入前、后两组HR-MRI对T分期的总体准确率分别为79.63%(43/54)、87.04%(47/54),Kappa值分别为0.687、0.802。结论腔内对比剂注入后HR-MRI图像质量较好、病变可视化程度较高,对直肠癌T分期具有较高的评估价值,尤其有利于早期直肠癌T分期诊断。

Objective To compare the quality of high resolution MRI(HR-MRI)image before and after intracavitary contrast medium injection and the diagnostic value of T staging for rectal cancer.Methods A total of 54 patients with rectal cancer confirmed by operation and pathology in our hospital from February 2016 to May 2017 were collected.All patients received HR-MRI scan before and after intracavitary contrast medium injection.The quality of the two groups of HR-MRI images before and after intracavitary contrast medium injection was compared.Two groups of HR-MRI were used for T staging and then compared with the postoperative pathological results.Results The good quality of HR-MRI images before and after intracavitary contrast injection were 81.48%(44/54)and 94.44%(51/54),respectively.The difference of image quality levels between the two groups was statistically significant(P<0.05).).Of the 54 patients,8 were in the pT1 phase,17 in the pT2 phase,25 in the pT3 phase,and 4 in the pT4 phase.Based on the pathological results,the overall accuracy of HR-MRI for T staging before and after intracavitary contrast injection was 79.63%(43/54),87.04%(47/54),and Kappa values were 0.687,respectively.0.802.Conclusion The quality of HR-MRI images after intracavitary contrast injection is better,and the degree of visualization of lesions is higher.It has a higher evaluation value for T stage of rectal cancer,especially for the diagnosis of T stage in early rectal cancer.