3.0T MRI在直肠癌诊断及术前TN分期中的临床应用

目的探究临床上在直肠癌诊断及术前TN分期中应用3.0T MRI的意义。方法将我院收治68例的直肠癌患者,采用3.0T MRI检查对患者进行诊断和术前TN分期,将检查结果与手术病理结果进行对比。结果比较术前与手术病理T分期诊断,经Kappa检验后,一致性较高(k=0.61,P0.05),诊断的正确率为89.71%,T1期诊断的准确率、特异性和阳性预测值最高,T2期诊断的敏感性最高,T4期诊断的阴性预测值最高;比较术前与手术病理N分期诊断,经Kappa检验后,一致性较高(k=0.54,P0.05),诊断的正确率为69.12%,N2期诊断的准确率、特异性、阳性预测值和阴性预测值最高,N0期诊断的敏感性最高;3.0T MRI与病理检查结果的肿瘤下缘距肛缘的距离无明显差异(P0.05)。结论 3.0T MRI在直肠癌的诊断及术前TN分期方面的准确率高,可为临床手术治疗提供依据,值得推广应用。

Clinical Application of MRI 3.0T in the Diagnosis and Preoperative TN Staging of Rectal Cancer

Objective To explore significance of clinical application of MRI 3.0T in the diagnosis and preoperative TN staging of rectal cancer.Methods 68 cases of rectal cancer diagnosed by pathologic biopsy in our hospital were selected, 3.0T MRI examination was used to diagnose and preoperative TN staging of the patients, the results were compared with surgical pathologic findings.Results Comparing the preoperative and surgical pathologic T staging by 3.0T MRI, after Kappa test, the consistency is high (k=0.61, P<0.05), the diagnostic accuracy was 89.71%, diagnosis accuracy, specificity and positive predictive value of T1 staging were the highest, diagnostic sensitivity of T2 staging was the highest, and negative predictive value of T4 staging was highest. Comparing the preoperative and surgical pathologic N staging by 3.0T MRI, after Kappa test, the consistency is high (k=0.54, P<0.05), the diagnostic accuracy was 69.12%, diagnosis accuracy, specificity, positive predictive value and negative predictive value of N2 were the highest, diagnostic sensitivity of N0 staging was the highest; there was no significant difference in the distance from the lower margin of the tumor to anal verge of 3.0T MRI and pathological results (P>0.05).Conclusion The accurate rate of MRI 3.0T in the diagnosis and preoperative TN staging of rectal cancer was high, can offer bases on clinical operation, is one ideal inspection method and worth spreading and applying.