高分辨率盆腔MRI扫描在直肠癌淋巴结转移中的应用价值研究

目的探究高分辨率盆腔MRI扫描在直肠癌淋巴结转移中的应用价值。方法选取2018年6月至2019年6月于我院接受诊治的直肠癌患者118例,根据病理学结果将患者分为淋巴结转移组和非淋巴结转移组。其中淋巴结转移组患者82例,非淋巴结转移组36例,两组患者均使用高分辨率盆腔MRI扫描方法进行检测,对淋巴结的ADC值、长径、短径、DCE-MRI定量参数(K^trans、V_e、V_ep)进行测量,对淋巴结转移组患者进行T、N分期观察。结果与淋巴结非转移组相比,淋巴结转移组ADC值下降,长径、短径上升,差异具有统计学意义(P<0.05);与淋巴结非转移组相比,K^trans、V_ep下降,V_e有所上升,差异具有统计学意义(P<0.05)在T分期方面,T_1-2期分期正确35例,1例患者病变分期不足,由T₃期被错误分到T_1-2期,T₃期正确35例,T₄期正确6例,经过高分辨率盆腔MRI扫描共正确81例,淮确率高达98.78%。T分期的准确率、敏感性、特异性、阳性预测值、阴性预测值均较高,T₄期的准确率、敏感性、特异性、阳性预测、阴性预测均高达100%。在N分期方面, N₀期分期正确42例,2例患者病变分期不足,由N_1-2期被错误分到N₀期,N_1-2期正确38倒,经过高分辨率盆腔MRI扫描共正确80例,准确率高达97.56%。N分期准确率、敏感性、特异性、阳性预测、阴性预测均相对高。结论除传统径线测量外,高分辨率盆腔MRI还可通过ADC值和增强MRM定量参数进行精准分析,使直肠癌淋巴结转移预测的精确度更高,同时高分辨率盆腔MRI能够有效应用于分期治疗中,有助于临床术前总体规划,对全面、合理的治疗具有重要临床意义。

Application of High Resolution Pelvic MRI In Lymph Node Metastasis of Rectal Cancer

Objective To explore the application value of high-resolution Pelvic MRI in lymph node metastasis of rectal cancer.Methods From June 2018 to June 2019,118 patients with rectal cancer who were diagnosed and treated with our hospital were selected.According to the pathological diagnosis of lymph node metastasis,the patients were divided into lymph node metastasis group and non lymph node metastasis group.Among them,82 patients in the lymph node metastasis group and 36 patients in the non lymph node metastasis group were detected by high-resolution Pelvic MRI.ADC value,long diameter,short diameter,quantitative parameters(K^trans,V_e,V_ep)of DCE-MRI were measured,and TNM stage of rectal cancer lymph node was detected.Results Compared with the non-metastatic lymph node group,the ADC value of the lymph node metastasis group decreased,while the long and short diameters increased,the difference was statistically significant(P<0.05);compared with the non-metastatic lymph node group,K^trans and V_ep decreased,V_e increased,the difference was statistically significant(P<0.05);in terms of T stage,35 patients had correct T_1-2 stage,one patient had insufficient lesion stage,and was misclassified from T₃ stage.There were 35 correct cases in T_1-2 stage,35 correct cases in T₃ stage and 6 correct cases in T₄ stage.A total of 81 correct cases were obtained by high-resolution pelvic MRI scanning,with an accuracy rate of 98.78%.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of T stage were higher,and the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of T₄ stage were all up to 100%.In terms of N staging,there were 42 cases with correct N₀ staging,2 cases with insufficient lesion staging,which were misclassified into N₀ stage by N_1-2 stage,38 cases with correct N_1-2 stage,and 80 cases with correct pelvic MRI scanning by high resolution,with an accuracy of 97.56%.The accuracy,sensitivity,specificity,positive prediction and negative prediction of N staging were relatively high.Conclusion In the high-resolution Pelvic MRI scan of rectal cancer lymph node metastasis,the ACD value of rectal cancer lymph node detection quantitative analysis is precisely measured,which makes the accuracy of rectal cancer lymph node metastasis further,and can be effectively applied in the staging treatment,which is conducive to the clinical preoperative total body planning,and comprehensive and reasonable treatment has important clinical significance.