高分辨率MRI动态增强扫描在直肠癌术前TN分期及手术方式选取中的应用  

Application of high resolution dynamic enhanced MR scan in TN staging and operation mode selection of rectal cancer before operation

作　　者：刘金玲 林吉征[1] 苏晓 曲雪廷 张亮[1] LIU Jinling;LIN Jizheng;SU Xiao;QU Xueting;ZHANG Liang(Department of Radiology,Affiliated Hospital of Medical College,Qingdao University,Qingdao 266003,China;Department of Radiology,Qingdao Municipal Hospital,Shandong Province,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院放射科,青岛266003 [2]青岛市市立医院放射科,青岛266003

出　　处：《磁共振成像》2021年第1期38-42,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨高分辨率MRI动态增强扫描在直肠癌术前TN分期及手术方式选取中的应用价值。材料与方法回顾性分析本院经肠镜病理确诊的154例直肠癌患者,所有患者均于术前接受高分辨率MRI动态增强扫描并进行肿瘤TN分期,根据术前分期结果拟定手术方式,比较术前拟定手术方式与最终手术方式的差异。结果154例直肠癌患者中,高分辨率MRI动态增强扫描对于直肠癌MRI表现T分期准确性为87.7%,N分期准确性为38.9%。拟定术式与实际术式符合率为95.5%,差异无统计学意义(P=0.480),拟定术式与实际术式一致性很强(Kappa值=0.873)。117例中高位直肠癌拟定手术方式与实际手术方式的符合率为98.2%,拟定术式与实际术式一致性很强(Kappa值=0.915)。37例低位直肠癌拟定手术方式与实际手术方式符合率为86.5%,拟定术式与实际术式一致性较强(Kappa值=0.643)。结论高分辨率MRI动态增强扫描对于直肠癌术前T分期的准确度、敏感度及特异度较高,与病理诊断相接近,拟定手术方式与实际手术方式一致性高,高分辨率MRI动态增强扫描对于直肠癌术前T分期及手术方式的选择有较高的临床应用价值。Objective:To investigate the application value of high resolution MRI dynamic enhanced scan in TN staging and operation mode selection of rectal cancer before operation.Materials and Methods:A retrospective analysis was performed on 154 patients with rectal cancer confirmed by surgery and pathology in our hospital.All the patients received high resolution dynamic enhanced MR scan before surgery and underwent tumor TN staging.According to the results of preoperative staging,the operative method was proposed,and the difference between the preoperative planned and the final operative method was compared.Results:Among the 154 patients with rectal cancer,the accuracy of T staging and N staging by high resolution MRI was 87.7%and 38.9%,respectively,The coincidence rate between the proposed operation and the actual one was 95.5%,with no statistically significant difference(P=0.480).The proposed operation and the actual one were highly consistent(Kappa value=0.873).The coincidence rate between the proposed surgical method and the actual surgical method was 98.2%in 117 patients with medium and high rectal cancer,and the proposed surgical method was highly consistent with the actual surgical method(Kappa value=0.915).In 37 cases of low rectal cancer,the coincidence rate between the proposed operation method and the actual operation method was 86.5%,and the proposed operation method was highly consistent with the actual operation method(Kappa value=0.643).Conclusions:High-resolution MRI dynamic enhancement scanning for sensitivity and accuracy of the preoperative T staging of rectal cancer specific degree is higher,and the pathological diagnosis phase close,to formulate the operation mode and the actual operation mode high consistency,high resolution MRI dynamic enhancement scanning for the preoperative T staging of rectal cancer and the selection of surgical procedure with high clinical application value.

关 键 词：直肠癌 磁共振成像 高分辨率 肿瘤分期 动态增强 手术方式 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]