MRI常规序列结合HR-MRI在直肠癌术前分期中应用研究

目的探讨MRI常规序列结合高分辨率磁共振成像(HR-MRI)在直肠癌术前分期中应用价值。方法回顾性分析71例经临床病理证实为直肠癌患者的术前MRI检查资料,并与术后病理对比。结果以术后病理检查结果作为"金标准",术前MRI常规序列与HR-MRI诊断直肠癌T分期总准确性为87.5%;其中T1期的准确性、敏感性、特异性分别为94.44%、81.82%、98.33%,T2期准确性、敏感性、特异性分别81.59%、83.33%、80.85%,T3期准确性、敏感性、特异性分别为98.51%、93.10%、92.86%,T4期准确性、敏感性、特异性均为100%;N分期的准确性84.51%,敏感性84.0%,特异性84.78%;直肠系膜筋膜的准确性88.73%,敏感性81.25%,特异性90.91%。结论 MRI常规序列及HR-MRI可评估直肠前术前T分期、N分期及直肠系膜筋膜侵犯情况,可为临床确定手术方案提供客观资料。

Application of MRI Routine Sequence Combined with HR-MRI in Preoperative Staging of Rectal Cancer

Objective To evaluate the value of MRI routine sequence combined with high resolution magnetic resonance imaging (HR-MRI) in preoperative staging of rectal cancer.Methods The preoperative MRI data of 71 patients with rectal cancer confirmed by clinical pathology were analyzed retrospectively.Results With the results of postoperative pathological examination as golden standard, the total accuracy of preoperative MRI routine sequence and HR-MRI in diagnosis of T staging of rectal cancer was 87.5%. The accuracy, sensitivity and specificity in the diagnosis of T1 stage were 94.44%, 81.82% and 98.33% respectively, of T2 stage were 81.59%, 83.33% and 80.85% respectively, of T3 stage were 98.51%, 93.10% and 92.86% respectively, of T4 stage all were 100%, and of N staging were 84.51%, 84.0% and 84.78% respectively. The accuracy, sensitivity and specificity in the diagnosis of mesorectal fascia were 88.73%, 81.25% and 90.91% respectively.Conclusion MRI routine sequence and HR-MRI can be used to evaluate preoperative T staging, N staging and mesorectal fascia invasion of rectal cancer and can provide objective data for determination of surgical plan.