高分辨率MRI对直肠癌TN分期及肠壁外脉管侵犯的诊断价值

目的 探究高分辨率磁共振成像（MRI）对直肠癌TN分期及肠壁外脉管侵犯的诊断价值。方法 回顾分析2020年1月至2020年12月阜阳市人民医院收入院的74例直肠癌患者临床资料，所有患者均接受了高分辨率MRI检测。以病理诊断直肠癌TN分期及肠壁外脉管侵犯为金标准，比较高分辨率MRI诊断直肠癌T分期、N分期及肠壁外脉管侵犯与病理诊断的差异，采用Kappa一致性检验分析高分辨率MRI与病理检测对直肠癌TN分期及肠壁外脉管侵犯诊断结果的一致性。结果 高分辨率MRI诊断直肠癌T分期、N分期及肠壁外脉管侵犯准确性低于与病理诊断，且差异有统计学意义（P<0.05）。高分辨率MRI序列诊断直肠癌T2期、T3期、T4期的一致性Kappa值分别为0.612、0.516和0.750，诊断直肠癌N0期、N1期、N2期的一致性Kappa值分别为0.437、0.544和0.448，检测肠壁外脉管侵犯的一致性Kappa值为0.634。结论 高分辨MRI用于直肠癌TN分期及肠壁外脉管侵犯的诊断，诊断效能尚可，与病理诊断一致性中等。

The diagnostic value of high resolution MRI in TN staging and extramural vascular invasion of rectal cancer

Objective To investigate the diagnostic value of high-resolution magnetic resonance imaging(MRI) in the TN staging of rectal cancer and extramural vascular invasion. Methods A retrospective analysis was conducted on the clinical data of 74 patients with rectal cancer admitted to Fuyang City People''s Hospital from January 2020 to December 2020. All patients underwent high-resolution MRI examination. Using pathological diagnosis of rectal cancer TN staging and extramural vascular invasion as the gold standard, the differences between high-resolution MRI diagnosis of rectal cancer T staging, N staging, and extramural vascular invasion and pathological diagnosis were compared. Kappa consistency test was used to analyze the consistency between high-resolution MRI and pathological detection in the diagnosis of rectal cancer TN staging and extramural vascular invasion. Results The accuracy of high-resolution MRI in diagnosing rectal cancer T staging, N staging, and extramural vascular invasion was lower than that of pathological diagnosis, and the differences were statistically significant(P<0.05). The Kappa valuefor the consistency of high-resolution MRI in diagnosing T2, T3, and T4 stages of rectal cancer was 0.612, 0.516, and 0.750, respectively. The Kappa value for the consistency of diagnosing N0, N1, and N2 stages of rectal cancer was 0.437, 0.544, and 0.448, respectively. The Kappa value for detecting extramural vascular invasion was 0.634. Conclusion High-resolution MRI for diagnosing rectal cancer TN staging and extramural vascular invasion demonstrates acceptable diagnostic efficacy, with moderate consistency compared to pathological diagnosis.