高分辨磁共振成像在直肠癌壁外血管侵犯(EMVI)评估中的价值

Evaluation of Extramural Vascular Invasion in Rectal Cancer with High Resolution MRI

[目的]探讨高分辨MRI在直肠癌壁外血管侵犯(EMVI)评估中的价值。[方法]回顾性分析109例经病理证实的直肠癌患者,术前行高分辨MRI检查。MRI评估EMVI的情况,并与手术病理对照。[结果] 109例患者中,病理学显示EMVI阳性18例,EMVI阴性91例;MRI显示EMVI阳性16例,EMVI阴性93例,正确诊断103例,MRI诊断EMVI准确率为94.50%(103/109),过高诊断2例,过低诊断4例。MRI与病理学对EMVI阳性的诊断一致性良好(Kappa值=0.791,P<0.001)。[结论]高分辨MRI对直肠癌术前EMVI的准确性较好,MRI能够为直肠癌的个体化治疗方案提供影像学依据。

[Objective]To assess the application of high resolution MRI in evaluation of vascular wall invasion(EMVI)for rectal cancer patients.[Methods]One hundred and nine patients with pathologically confirmed rectal cancer underwent preoperative high-resolution MRI examination.The application of MRI in detection of EMVI was evaluated by comparing with pathological results.[Results]Among 109 patients,pathology showed 18 cases with positive EMVI and 91 cases with negative EMVI;MRI showed positive EMVI in 16 cases,and negative EMVI in 93 cases.The Kappa test showed that MRI was well consistent with pathological results for EMVI(Kappa coefficient=0.791,P<0.001).With pathological finding as a golden standard the diagnostic accuracy of MRI was 94.5%(103/109).Two cases were over-diagnosed and 4 cases was under-diagnosed by MRI.[Conclusion]High-resolution MRI shows a good accuracy in preoperative diagnosis of EMVI for rectal cancer patients.