MRI增强与直肠双重超声造影在直肠癌术前TN分期中的应用效果比较

 目的 比较MRI增强与直肠双重超声造影在直肠癌术前TN分期中的应用效果。方法 选取2015-03至2018-03医院接受治疗的84例直肠癌患者为研究对象,所有患者均于术前一周接受MRI和双重超声造影检查并知情同意。对MRI检查患者均采取常规高分辨率冠状T₂WI、轴位T₁WI扫描,扩散加权成像和加强扫描;对直肠双重超声造影(double contrast-enhanced ultrasonography ,DCEUS)采取定量对比谐波成像技术示踪微泡造影显像检查。采用SPSS19.0统计学软件对影像学诊断结果与病理进行一致性分析,用χ²检验对两组进行比较,对比两组在直肠癌术前TN分期中的诊断效果。结果 MRI对直肠癌T分期的诊断准确率为80.95%(68/84),DCEUS对直肠癌T分期的诊断准确率为86.90%(73/84),MRI和DCEUS评估直肠癌术前T分期与术后病理组织学一致性均较好(Kappa=0.518;Kappa=0.611)。MRI对N期的诊断精准率为73.81%(62/84),DCEUS对N分期的诊断精准率为63.10%(53/84),MRI评估N分期与病理组织学分期一致性好(Kappa=0.802),DUES评估N分期与病理组织学分期一致性较好(Kappa=0.694)。二者对TN分期精确度无明显差异,不具统计学意义(T期χ²=2.12,N期χ²=1.37)。结论 MRI多系列成像技术和多方位观察更有利于病变部位的显示,能够更好指导直肠癌的手术形式和治疗方案。

Enhanced MRI and transrectal double contrast-enhanced ultrasonography in preoperative staging of rectal cancer

Objective To evaluate the effect of contrast-enhanced MRI and transrectal double contrast-enhanced ultrasonography (DCEUS) in preoperative TN staging of rectal cancer.Methods Eighty-four patients with rectal cancer treated in our hospital between March 2015 and March 2018 were selected as the subjects. One week before the operation, the patients signed the informed consent form and underwent MRI and DCEUS examination. The results of examination were compared with those of histopathological evaluation while SPSS 19.0 software was used to analyze the data collected.Results The accuracy of T staging was 80.95% (68/84) for MRI and 86.9% for DCEUS(73/84). Both were well consistent (Kappa = 0.518 and 0.611 respectively) with histopathological evaluation. The accuracy of N staging with MRI was 73.81% (62/84), compared with 63.1% with DCEUS(53/84). Both had very good consistency (Kappa=0.802 and 0.694 respectively) with histopathological evaluation. There was no statistically significant difference in TN staging between them(χ²=2.12, for T staging P>0.05 and χ²=1.37 for N staging,P>0.05).Conclusions MRI is more acceptable than DCEUS,which can offer better and more effective guidance to rectal cancer surgery.