128层CT与MRI术前诊断直肠癌的应用分析  

Application of 128-Slice CT and MRI in the Preoperative Diagnosis of Rectal Cancer

作　　者：张玉英[1] 马骏[2] 董燕 孙晓峰[4] ZHANG Yu-ying;MA Jun;DONG Yan;SUN Xiao-feng(Department of Radiology,Department of general surgery,Shenyang 110024,Liaoning Province,China;Department of Urology,Department of Anesthesiology,Affiliated Central Hospital of Shenyang Medical College,Shenyang 110024,Liaoning Province,China;Department of Urology,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,Liaoning Province,China;Department of Anesthesiology,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,Liaoning Province,China)

机构地区：[1]沈阳医学院附属中心医院放射线科,辽宁沈阳110024 [2]沈阳医学院附属中心医院普外四科,辽宁沈阳110024 [3]沈阳医学院附属中心医院泌尿内科,辽宁沈阳110024 [4]沈阳医学院附属中心医院麻醉科,辽宁沈阳110024

出　　处：《中国CT和MRI杂志》2023年第3期153-154,169,共3页Chinese Journal of CT and MRI

基　　金：2018年度辽宁省自然科学基金计划项目(编号28)。

摘　　要：目的 探讨直肠癌术前诊断中,128层CT与MRI的应用价值。方法 选取2019年5月至2021年1月本院120例直肠癌患者,以病理结果作为金标准,分析CT与MRI对于疾病术前分期和淋巴结转移的判别效能。结果CT检测直肠癌术前TNM分期包括T1-2期25例,T3期61例,T4期34例;MRI检测直肠癌术前TNM分期包括T1-2期26例,T3期58例,T4期36例;MRI.对直肠癌T1-2、T3、T4分期诊断准确度.分别为95.00%、87.50%、92.50%高于CT诊断87.50%、71.67%、84.17%,与病理结果的Kappa一致性分别为0.857、0.749、0.823高于CT诊断0.637、0.434、0.620(P<0.05);术前CT扫描共检测出淋巴结转移阳性71例,阴性49例;MRI共检测出淋巴结转移阳性70例,阴性50例;MRI判断直肠癌淋巴结转移准确率90.83%高于CT扫描78.33%,与病理结果的Kappa一致性为0.812高于CT扫描0.554(P<0.05)。结论 MRI相较于128层CT对于直肠癌临床分期和淋巴结转移的诊断正确率更高,可为临床手术治疗提供依据。Objective To explore the application value of 128-slice CT and MRI in the preoperative diagnosis of rectal cancer.Methods A total of 120 patients with rectal cancer in the hospital were enrolled between May 2019 and January 2021.Taking pathological results as the golden standard,determining efficiency of CT and MRI for preoperative staging of diseases and lymph node metastasis was analyzed.Results CT detection showed that there were 25 cases with preoperative TNM staging of rectal cancer at stage T1-2,61 cases at T3 and 34 cases at T4.MRI detection showed that there were 26 cases with preoperative TNM staging of rectal cancer at stage T1-2,58 cases at T3 and 36 cases at T4.The diagnostic accuracy rates of MRI for rectal cancer at stages T1-2,T3 and T4 were 95.00%,87.50%and 92.50%,higher than those of CT(87.50%,71.67%,84.17%).Kappa consistency of MRI with pathological results were 0.857,0.749 and 0.823,higher than those of CT(0.637,0.434,0.620)(P<0.05).CT scan showed that there were 71 cases with positive lymph node metastasis and 49 cases with negative.MRI showed that there were 70 cases with positive lymph node metastasis and 50 with negative.The accuracy rate of MRI in determining lymph node metastasis of rectal cancer was higher than that of CT scan(90.83%vs 78.33%),and the Kappa consistency of MRI with pathological results was higher than that of CT scan(0.812 vs 0.554)(P<0.05).Conclusion Compared with 128-slice CT,diagnostic accuracy rates of MRI are relatively higher for clinical staging and lymph node metastasis of rectal cancer,which can provide basis for clinical surgical treatment.

关 键 词：直肠癌 电子计算机断层扫描 磁共振成像 术前诊断 分期 淋巴结转移 

分 类 号：R445.2[医药卫生—影像医学与核医学]