高分辨磁共振成像诊断直肠癌壁外血管侵犯价值的探讨  

Value of the high-resolution magnetic resonance imaging in diagnosis of extramural vascular invasion of rectal cancer

作　　者：佘波[1] 吴昆华[2] 季云海[1] 赵英[2] 张宏江[2] 陈婧[2] 梁锐[3] 宋巍[4] 

机构地区：[1]云南省第一人民医院PET/CT中心,云南昆明650000 [2]云南省第一人民医院磁共振科,云南昆明650000 [3]云南省第一人民医院病理科,云南昆明650000 [4]云南省第一人民医院放射科,云南昆明650000

出　　处：《实用放射学杂志》2016年第12期1890-1893,1911,共5页Journal of Practical Radiology

摘　　要：目的：探讨高分辨磁共振成像（HRMRI）诊断直肠癌壁外血管侵犯（EMVI）的价值。方法回顾本院经手术治疗的33例直肠癌患者术前磁共振图像,将 EMVI磁共振评分与术后病理结果进行比较分析。结果 EMVI 磁共振评分阴性、阳性与病理对照之间具有一致性（k=0.324,P=0.039）,EMVI磁共振评分与病理结果对照的准确率为66.7%（22/33）。EMVI 磁共振评分随着病理T分期（pT分期）升高,二者之间的关联性较好（r=0.546）。EMVI 磁共振评分阳性比率随着病理 T 分期（pT 分期）升高,二者之间的关联性较好（r=0.469）。受试者工作特征曲线（ROC）分析证明 EMVI磁共振评分是诊断直肠癌 EMVI有效的方法（AUC=0.757）。结论 HRMRI是诊断直肠癌 EMVI的一种有价值的方法。Objective To investigate the value of high-resolution magnetic resonance imaging （HRMRI）in diagnosis of extramural vascular invasion （EMVI）of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings （k=0.324,P=0.039）.The accuracy rate of MRI in diagnosis of EMVI was 66.7% （22/33）.The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both （r=0.546）.The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both （r=0.469）. ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI （AUC=0.757）.Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.

关 键 词：直肠癌 壁外血管侵犯 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]