磁共振成像在直肠癌术前TN分期及肠旁淋巴结转移诊断中的应用价值  

Application value of MRI in preoperative TN staging and paraintestinal lymph node metastasis of rectal cancer

作　　者：杨晓庆 远波 Yang Xiaoqing;Yuan Bo(Department of Magnetic Resonance,Zhumadian Central Hospital,Henan 463000,China)

机构地区：[1]河南省驻马店市中心医院磁共振科,463000

出　　处：《实用医学影像杂志》2022年第3期246-248,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨磁共振成像(MRI)在直肠癌术前TN分期及肠旁淋巴结转移诊断中的应用价值。方法选取2019年2月至2021年3月在我院接受治疗的90例直肠癌患者,所有患者在术前均进行3.0 T MAGNETOM Skyra MRI序列扫描,将手术病理结果作为“金标准”,评估3.0 T MAGNETOM Skyra MRI序列对直肠癌术前TN分期及肠旁淋巴结转移诊断情况。结果病理结果诊断T_(1)期8例、T_(2)期12例、T_(3)期44例、T_(4)期26例,MRI诊断的Kappa值为0.62,一致性较好(P<0.05),其中误诊11例,漏诊11例;病理结果诊断N_(0)期51例、N_(1)期25例、N_(2)期14例,MRI诊断的Kappa值为0.42,一致性中度(P<0.05),其中误诊数有11例,漏诊数有21例;病理结果诊断肠旁淋巴结转移阳性43例,阴性47例,以病理为标准MRI准确检出阳性23例,阴性35例,灵敏度为53.5%,特异度为74.5%,阳性预测值为65.7%,阴性预测值为63.6%,准确度为64.4%,Kappa值为0.28。结论MRI在直肠癌术前T分期诊断的一致性较好,应用价值良好,在N分期诊断的一致性中等,准确率一般;预测肠旁淋巴结转移的特异度较高。Objective To explore the application value of magnetic resonance imaging(MRI)in preoperative TN staging and diagnosis of lymph node metastasis of rectal cancer.Methods Ninety patients with rectal cancer who were treated in our hospital from February 2019 to March 2021 were selected.All patients were scanned with 3.0T MAGNETOM Skyra MRI sequence before operation,and the pathological results were taken as the"gold standard".The diagnosis of preoperative TN staging and lymph node metastasis of rectal cancer by 0T MAGNETOM Skyra MRI sequence were evaluated.Results Pathological results showed that 8 cases were diagnosed in T_(1),12 cases in T_(2),44cases in T_(3)and 26 cases in T_(4),The Kappa value of MRI diagnosis was 0.62,P<0.05,which was consistent with each other,including 11 cases were misdiagnozed and 11 cases were missed diagnozed.Pathological results showed that 51cases were diagnosed as N_(0),25 cases as N_(1)and 14 cases as N_(2),the Kappa value of MRI diagnosis was 0.42,P<0.05,with moderate consistency.Among them,11 cases were misdiagnozed and 21 cases were missed diagnozed.Pathological results showed that 43 cases were positive and 47 cases were negative.MRI accurately detected positive in 23case and negative in 35 cases with pathology as standard,with sensitivity of 53.5%,specificity of 74.5%,positive predictive value of 65.7%,negative predictive value of 63.6%,accuracy of 64.4%and Kappa value of 0.28.Conclusion MRI has good consistency and application value in preoperative T staging diagnosis of rectal cancer.The consistency of N staging diagnosis is moderate and the accuracy is average.The specificity of predicting lymph node metastasis is high.

关 键 词：磁共振成像 直肠肿瘤 肠旁淋巴结转移 TN分期 

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]