高分辨T2联合弥散加权成像在直肠癌术前TNM分期评估中的应用价值  

Application Value of High Resolution T2 Combined with Diffusion Weighted Image in Preoperative TNM Staging and Assessment of Rectal Cancer

作　　者：李晓维 张伯英 程秋波 轩翠华 LI Xiao-wei;ZHANG Bo-ying;CHENG Qiu-bo;XUAN Cui-hua(Magnetic Resonance Imaging Room,989 Hospital of Joint Logistic Support Force,Luoyang,Henan 471000)

机构地区：[1]联勤保障部队第九八九医院磁共振室,河南洛阳471000

出　　处：《中国肛肠病杂志》2024年第6期5-7,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨高分辨磁共振(MR)T2加权成像(T2WI)联合弥散加权成像(DWI)在直肠癌患者术前TNM分期中的应用价值。方法:选取2021年1月至2023年1月,本院收治的102例直肠癌患者,术前均行T2WI和DWI序列扫描,以病理诊断结果为金标准,采用Kappa一致性检验法评估T2WI联合DWI行TNM分期的一致性。结果:T2WI联合DWI诊断直肠癌T分期的总准确率为90.20%(92/102),与病理T分期的一致性极好(Kappa值=0.864,P<0.05),其中T1、T2、T3和T4期的灵敏度、特异度及准确度分别为100.00%、98.84%、99.02%;82.35%、95.29%、93.14%;92.00%、93.06%、92.62%;84.21%、100.00%、97.06%。T2WI联合DWI诊断直肠癌N分期的总准确率为79.41%(81/102),与病理N分期的一致性良好(Kappa值=0.705,P<0.05),其中N0、N1、N2期的灵敏度、特异度和准确度分别为87.30%、87.18%、87.25%;56.52%、86.08%、79.41%;81.25%、94.19%、92.16%。结论:T2WI联合DWI诊断直肠癌TNM分期的准确度较高,有助于为临床诊断提供参考依据。Objective To investigate the application value of high resolution magnetic resonance(MR)T2 weighted imaging(T2 WI)combined with diffusion weighted imaging(DWI)in the preoperative TNM staging of rectal cancer patients.Methods A total of 102 patients with rectal cancer admitted to our hos-pital from January 2021 to January 2023 were selected for preoperative T2 WI and DWI sequential scan-ning.The consistency of TNM staging on T2 WI combined with DWI was evaluated by Kappa consistency test using pathological diagnosis results as the gold standard.Results The total accuracy rate of T2 WI combined with DWI in the diagnosis of T staging of rectal cancer was 90.20%(92/102),and the consis-tency with the pathological T staging was very good(Kappa=0.864,P<0.05).The sensitivity,speci-ficity and accuracy of T1,T2,T3 and T4 stages were respectively 100.00%,98.84%and 99.02%;82.35%,95.29%and 93.14%;92.00%,93.06%and 92.62%;84.21%,100.00%and 97.06%.The over-all accuracy rate of T2 WI combined with DWI in the diagnosis of N staging of rectal cancer was 79.41%(81/102),which was in good agreement with pathological N staging(Kappa=0.705,P<0.05).The sensitivity,specificity and accuracy of N0,N1 and N2 stages were respectively 87.30%,87.18%and 87.25%;56.52%,86.08%and 79.41%;81.25%,94.19%and 92.16%.Conclusion The accuracy rate of T2 WI combined with DWI in the diagnosis of TNM staging of rectal cancer is higher,which is helpful to provide reference for clinical diagnosis.

关 键 词：直肠癌 T2加权成像 弥散加权成像 TNM分期 

分 类 号：R735.37[医药卫生—肿瘤]