光谱CT联合MRI检查在结直肠癌T分期诊断中的价值  

Clinical application of spectral CT combined with MRI in preoperative staging diagnosis of colorectal cancer

作　　者：瞿俊晨[1] 俞铖[2] 何宋兵[3] QU Junchen;YU Cheng;HE Songbing(Department of Imaging,Changshu No.2 People's Hospital,Changshu,Jiangsu 215500,China;Department of Gastrointestinal Surgery,Changshu No.2 People's Hospital,Changshu,Jiangsu 215500,China;Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]常熟市第二人民医院影像科,江苏常熟215500 [2]常熟市第二人民医院胃肠外科,江苏常熟215500 [3]苏州大学附属第一医院普外科,江苏苏州215000

出　　处：《中国肿瘤外科杂志》2023年第1期60-65,共6页Chinese Journal of Surgical Oncology

基　　金：常熟市卫生健康委员会科技计划项目(cswsq201909);常熟市科技发展计划项目(CS202035);苏州市医工结合协同创新研究项目(SLJ2021007);苏州市姑苏卫生重点人才项目(GSWS2020005)。

摘　　要：目的研究光谱电子计算机断层扫描(CT)联合磁共振成像(MRI)在结直肠癌术前T分期中的诊断价值。方法选择常熟市第二人民医院2018年4月至2021年10月收治的74例结直肠癌患者,均在我院行光谱CT和MRI术前检查,并于术中取癌组织进行病理诊断,将单独光谱CT检查结果、单独MRI检查结果、光谱CT联合MRI检查结果与病理诊断结果比较,分析三种检查方式对结直肠癌术前T分期的诊断效能。结果光谱CT检查结果有62例(83.78%)与病理诊断结果一致,有12例(16.22%)不一致,单独光谱CT检查对结直肠癌术前T分期诊断准确率为83.78%;MRI检查结果有56例(75.68%)与病理诊断结果一致,有18例(24.32%)不一致,单独MRI检查对结直肠癌术前T分期诊断准确率为75.68%;光谱CT联合MRI检查结果有71例(95.95%)与病理诊断结果一致,有3例(4.05%)不一致,光谱CT联合MRI检查对结直肠癌术前T分期诊断准确率为95.95%。光谱CT联合MRI检查的诊断效能高于单独光谱CT检查及MRI检查(χ^(2)=6.010、12.490,P<0.05),单独光谱CT与MRI的诊断效能无明显差异(χ^(2)=1.510,P>0.05)。结论术前应用光谱CT联合MRI检测有助于准确评估结直肠癌患者肿瘤T分期情况。Objective To study the diagnostic value of spectral computed tomography(CT)combined with magnetic resonance imaging(MRI)in preoperative T staging of colorectal cancer(CRC).Methods A total of 74 CRC patients who were treated in our hospital from April 2018 to October 2021 were included.All of them underwent preoperative spectral CT and MRI examinations in our hospital,and tissues were taken for pathological diagnosis during the operation.The results of spectral CT examination alone,MRI examination alone,spectral CT combined with MRI examination and pathological diagnosis results were compared to analyze the diagnostic efficacy of the three examination methods for preoperative T staging of CRC.Results Spectral CT examination results were consistent with pathological diagnosis in 62 cases(83.78%),and inconsistent in 12 cases(16.22%).Spectral CT examination alone had an accuracy of 83.78%in preoperative T staging of CRC;56 cases(75.68%)of the MRI findings were consistent with the pathological diagnosis,and 18(24.32%)were inconsistent.The accuracy of preoperative staging of CRC by MRI alone was 75.68%;The results of spectral CT combined with MRI were consistent with pathological diagnosis in 71 cases(95.95%),and 3 cases(4.05%)were inconsistent.The diagnostic accuracy rate of spectral CT combined with MRI in preoperative T staging of CRC was 95.95%.Among the three detection methods,spectral CT combined with MRI had the highest diagnostic performance(χ^(2)=6.010,12.490,P<0.05),and there was no significant difference in the diagnostic performance between spectral CT and MRI alone(χ^(2)=1.510,P>0.05).Conclusions In order to accurately evaluate the tumor T staging of CRC patients,spectral CT combined with MRI can be used before surgery,which is conducive to the selection of surgical methods and treatment guidance.

关 键 词：光谱CT 磁共振成像 结直肠癌 肿瘤分期 诊断效能 

分 类 号：R735.34[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44