高分辨MRI评估直肠癌术前分期及环周切缘的应用价值  

Prediction of Extramural Venous Invasion in Rectal Cancer:Comparison of The Radiometrics Models And Magnetic Resonance Imaging Quantitative Parameters for Diagnostic Effectiveness

作　　者：王林[1] 汪志强 肖兰 敬文波 赵志伟[2] 王玲[1] WANG Lin;WANG Zhi-qiang;XIAO Lan;JING Wen-bo;ZHAO Zhi-wei;WANG Ling(Department of Radiology,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,Hubei Province,China;Department of MRI,the Tumor Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]湖北省中医院放射科,湖北武汉430074 [2]新疆医科大学附属肿瘤医院磁共振室,新疆乌鲁木齐830011

出　　处：《中国CT和MRI杂志》2022年第9期158-160,共3页Chinese Journal of CT and MRI

基　　金：青年医学科技人才专项科研项目(XJWY-201840)。

摘　　要：目的 HR-MRI在评估直肠癌术前分期及环周切缘方面的应用价值。方法 收集2015至2021就诊于我院并符合纳入排除标准的患者140例,患者均经手术病理证实为直肠癌,且术前均行直肠高分辨率MRI检查。H R-MRI评估直肠癌T、N分期、CRM受累情况与术后病理结果 证实的T、N分期、CRIM受累情况的一致性采用Kappa检验,P<0.01差异有统计学意义。评价MRI在诊断直肠癌术前T、N分期和CRM中的准确性。结果 MRI评估直肠癌T分期与病理T分期的一致性良好(Kappa值为0.79)、直肠癌N分期MRI评价与病理N分期一致性一般(Kappa值为0.621)、CRM受累情况MRI评价与病理结果 一致性良好(Kappa值为0.71),P<0.01差异有统计学意义。MRI评估直肠癌T分期总体准确率为87.9%(123/140)、N分期总体准确率为76.4%(107/140)、CRM受累总体准确率为90.0%(126/140)。结论 肿瘤的浸润深度、淋巴结转移情况及环周切缘受侵情况可以在HR-MR上得以清晰显示,这些结构的受侵情况对指导临床精准医疗有重要意义。Objective The application value of HR-MRI in evaluating preoperative staging and circumferential resection margin of rectal cancer.Methods A total of 140 patients who were admitted to our hospital from 2015 to 2021 and met the inclusion and exclusion criteria were collected.All patients were confirmed to be rectal cancer by surgery and pathology,and all patients underwent rectal high-resolution MRI examination before su rgery.The consistency of H R-MRI assessment of rectal cancer T,N staging,and CRM involvement with the T,N staging,and CRM involvement confirmed by postoperative pathological results was performed by Kappa test,and the difference was statistically significant at P<0.01.To evaluate the efficacy of MRI in diagnosing preoperative T,N staging,and CRM for rectal cancer.Results The consistency between MRI evaluation of rectal cancer T staging and pathological T staging was good(Kappa value was 0.79),and the consistency between MRI evaluation of rectal cancer N staging and pathological N staging was general(Kappa value 0.621).The consistency of pathological results was good(Kappa value was 0.71),and the difference was statistically significant at P<0.01.The overall accuracy of MRI rectal cancer assessment for T staging was 87.9%(123/140),the overall accu racy of N staging was 76.4%(107/140),and the overall accuracy of CRM involvement was 90.0%(126/140).Conclusion The depth of tumor invasion,lymph node metastasis,and the invasion of the circumferential resection margin can be displayed on HR-MR.The invasion of these structures is of great significance for guiding clinical precision medicine.

关 键 词：直肠癌 环周切缘 MRI 

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]