MRI在直肠癌术前分期中的作用

目的:评估盆腔MRI检查在直肠癌术前分期和治疗决策中的作用。方法:对2009年4月至2010年6月手术治疗的60例直肠癌病例的术前盆腔MRI检查结果与术后组织病理学诊断结果进行比较,分析MRI对直肠癌术前分期的准确率。结果:MRI对直肠癌浸润深度(T分期)的诊断准确率为75%,对T2期肿瘤的诊断准确率为73.1%,对T3期肿瘤的诊断准确率为86.7%;对淋巴结转移的诊断准确率为32.4%。在病理确诊淋巴结转移的16例病人中,MRI检出淋巴结平均数为5.8枚;在淋巴结转移阴性的44例病人中,MRI检出淋巴结平均数为2.4枚;两组淋巴结数有显著差异(P0.05)。结论:术前MRI检查可较准确地判断肿瘤在直肠壁的浸润深度,但对淋巴转移的诊断准确率较低,故MRI可作为直肠癌术前分期的方法,为新辅助治疗提供依据,为术后辅助化疗提供信息。

The value of preoperative MRI in tumor staging and choice of therapeutic procedure in rectal cancer

Objective To evaluate the value of MRI in preoperative tumor staging and choice of therapeutic procedure in rectal cancer.Methods Sixty cases of rectal cancer admitted between April 2009 and June 2010 were taken into the study;the results of preoperative pelvic MRI were analyzed and compared with that of histopathology.The accuracy of MRI for the staging of rectal cancer was evaluated.Results The accuracy rate of MRI was 75% for T staging in total,73.1% for stage T2,and 86.7 % for stage T3;and 32.4% for number of metastatic lymph nodes respectively.An average of 5.8 lymph nodes were found in MRI of patients with lymph node metastasis and 2.4 lymph nodes in patients without lymph node metastasis.The difference of lymph node numbers between these two groups was statistically significant（P0.05）.Conclusions MRI can help to predicate T staging of rectal cancer preoperatively,but not so accurate to predicate lymph node metastasis;it can help to provide valuable information for the choice of treatment.