磁共振T2加权成像联合弥散加权成像在老年直肠癌术前TN分期中的应用价值

目的探讨磁共振T2加权成像联合弥散加权成像在老年直肠癌术前TN分期中的应用价值。方法以2018年1月~2020年12月肿瘤科收治的74例老年直肠癌手术患者为研究对象,全部患者术前均接受磁共振检查,采用常规T2加权成像与弥散加权成像,以术后病理诊断结果为金标准,评价磁共振联合成像进行TN分期的准确率与一致性。结果磁共振T2加权成像联合弥散加权成像诊断T分期:T₁期7例、T₂期14例、T₃期28例、T₄期25例,基于金标准,诊断准确70例,准确率94.59%,误诊4例,均为高估,一致性检验Kappa值为0.832(P<0.05)。诊断N分期:N₀期13例、N₁期37例、N₂期24例(32.43%),基于金标准,诊断准确64例,准确率86.49%,误诊10例,包括7例高估和3例低估,一致性检验Kappa值为0.755(P<0.05)。结论磁共振T2加权成像联合弥散加权成像术前诊断老年直肠癌TN分期准确率较高,与术后病理诊断结果一致性良好,可以为个体化手术方案制定提供有价值的依据参考。

The application value of magnetic resonance T2-weighted imaging combined with diffusion-weighted imaging in preoperative TN staging of elderly rectal cancer

Objective To explore the application value of magnetic resonance T2-weighted imaging combined with diffusion-weighted imaging in preoperative TN staging of elderly rectal cancer.Methods Taking 74 elderly patients undergoing rectal cancer surgery from January 2018 to December 2020 in the department of oncology of our hospital as the research object,all patients underwent MRI examination before surgery,using conventional T2-weighted imaging and diffusion-weighted imaging,and postoperatively The pathological diagnosis result is the gold standard to evaluate the accuracy and consistency of MRI combined with TN staging.Results MRI T2-weighted imaging combined with diffusion-weighted imaging to diagnose T staging:7 cases in T₁ stage,14 cases in T₂ stage,28 cases in T₃ stage,25 cases in T₄ stage.Based on the gold standard,the diagnosis was accurate in 70 cases,the accuracy rate was 94.59%,and 4 cases were misdiagnosed,All are overestimated,and the Kappa value of the consistency test is 0.832(P<0.05).Diagnosis of N stage:13 cases of N₀ stage,37 cases of N₁ stage,24 cases of N₂ stage(32.43%).Based on the gold standard,64 cases were diagnosed accurately,with an accuracy rate of 86.49%,and 10 cases of misdiagnosis,including 7 overestimated cases and 3 underestimated cases,The Kappa value of the consistency test was 0.755(P<0.05).Conclusion Magnetic resonance T2-weighted imaging combined with diffusion-weighted imaging has a high accuracy in preoperative diagnosis of TN staging of elderly rectal cancer,and is consistent with the postoperative pathological diagnosis results.It can provide a valuable reference for the formulation of individualized surgical plans.