MR多模态成像在直肠癌TN分期及手术方式选择中的应用  

Value of multimodal magnetic resonance imaging for TN staging and surgical decision making in rectal cancer

作　　者：曲雪廷 李志明[3] 张亮[3] 娄和南 王国华[2] QU Xueting;LI Zhiming;ZHANG Liang;LOU Henan;WANG Guohua(Faculty of Medicine,Qingdao University,Qingdao 266073,China)

机构地区：[1]青岛大学医学部,山东青岛266073 [2]青岛市市立医院放射科 [3]青岛大学附属医院放射科

出　　处：《精准医学杂志》2024年第2期148-150,154,共4页Journal of Precision Medicine

基　　金：青岛大学附属医院临床医学+X项目(QDFY+X202101017)。

摘　　要：目的探讨MR多模态成像在直肠癌TN分期及手术方式选择中的应用价值。方法回顾性分析我院2020年1月—2022年5月396例直肠癌患者的MR征象,以此进行术前TN分期并模拟制定手术方式,分析手术前后TN分期的准确性,并比较拟定手术方式与实际手术方式的一致性。结果MR多模态成像辅助术前拟定直肠癌T分期的符合率为90.15%,与术后病理结果的一致性较高(K=0.82,P<0.01),且对于T2~T4分期的诊断准确率较高;N分期的符合率为71.46%,与术后病理结果的一致性适中(K=0.53,P<0.01)。MR多模态成像辅助拟定手术方式的符合率为89.14%,与实际术式一致性较高(K=0.79,P<0.01),且对于直肠癌各种术式拟定的准确率均较高。结论MR多模态成像对直肠癌的术前TN分期以及手术方式的制定有较高的临床价值。Objective To investigate the application value of multimodal magnetic resonance imaging(MRI)for TN staging and surgical decision making in rectal cancer.Methods We retrospectively analyzed the MRI features of 396 patients with rectal cancer treated in our hospital from January 2020 to May 2022 for preoperative TN staging and decision-making on surgical approaches.We analyzed the accuracy of TN staging assisted by multimodal MRI as well as the consistency between multimodal MRI-informed surgical decisions and actual surgical decisions.Results The coincidence rate of preoperative T staging of rectal cancer assisted by multimodal MRI was 90.15%,with high agreement with postoperative pathological results(K=0.82,P<0.01),and the diagnostic accuracy rates for T2 to T4 stages were high.The coincidence rate of N staging was 71.46%,with mode-rate agreement with postoperative pathological results(K=0.53,P<0.01).Surgical options selected with the assistance of multimodal MRI were 89.14%consistent with actual surgical decisions,indicating high agreement between the two(K=0.79,P<0.01),and the accuracy rates with multimodal MRI were high for all surgical approaches.Conclusion Multimodal MRI has great clinical value for preoperative TN staging of rectal cancer and surgical decision making.

关 键 词：直肠肿瘤 磁共振成像 多模态成像 肿瘤分期 外科手术 

分 类 号：R735.37[医药卫生—肿瘤]