高分辨MRI在评估下段直肠癌术前TN分期及环周切缘中的敏感性分析  

Sensitivity Analysis of High-resolution MRI in Preoperative TN Staging and Circumferential Margin Assessment of Lower Rectal Cancer

作　　者：林晓强 杨德军 周慧术 Lin Xiaoqiang;Yang Dejun;Zhou Huishu(Radiolog y Department,Liuzhou Traditional Chinese Medicine Hospital,Liuzhou,Guangxi 545001)

机构地区：[1]柳州市中医医院放射科,广西柳州545001

出　　处：《科技与健康》2024年第15期5-8,共4页Technology and Health

摘　　要：探讨高分辨MRI在评估下段直肠癌术前TN分期及环周切缘中的敏感性。选择65例下段直肠癌患者,对其实施盆腔高分辨MRI平扫,记录瘤体下缘与肛门外缘的距离、瘤体矢状位与斜轴位直径,完善MRI-TN分期,评估直肠系膜筋膜(MRF)及环周切缘受累状况,与术后病理结果进行对比。结果显示,65例下段直肠癌患者,MRI-T分期正确率为84.6%,与病理T分期的一致性好(Kappa值为0.757)。MRI-N分期正确率为67.7%,与病理N分期的一致性一般(Kappa值为0.514)。MRI对MRF受累与否的诊断准确率为90.8%(59/65),MRI-MRF与术后病理的一致性较好(Kappa值为0.789)。MRI检查明确环周切缘肿瘤浸润与否的准确率是92.3%(60/65),MRI-MRF与术后病理的一致性较好(Kappa值为0.662)。研究发现,高分辨MRI检查能准确进行直肠癌术前TN分期,可判断环周切缘的肿瘤发生率,有助于临床合理选择治疗方案。Exploring the sensitivity of high-resolution MRI in evaluating preoperative TN staging and circumferential margins of lower rectal cancer.Select 65 patients with lower rectal cancer and perform pelvic high-resolution MRI plain scan.Record the distance between the lower edge of the tumor and the outer edge of the anus,the sagittal and oblique diameters of the tumor,improve MRI-TN staging,evaluate the involvement of the mesorectal fascia(MRF)and the circumferential margin,and compare with postoperative pathological results.The results showed that in 65 patients with lower rectal cancer,the accuracy of MRI-T staging was 84.6%,which was consistent with pathological T staging(Kappa value of 0.757).The accuracy of MRI-N staging is 67.7%,which is generally consistent with pathological N staging(Kappa value of 0.514).The diagnostic accuracy of MRI for MRF involvement was 90.8%(59/65),and the consistency between MRI-MRF and postoperative pathology was good(Kappa value of 0.789).The accuracy of MRI examination in determining tumor infiltration at the circumferential margin is 92.3%(60/65),and the consistency between MRI-MRF and postoperative pathology is good(Kappa value of 0.662).Research has found that high-resolution MRI can accurately perform preoperative TN staging of rectal cancer,determine the incidence of tumors at the circumferential margin,and help in the rational selection of treatment plans in clinical practice.

关 键 词：磁共振成像 下段直肠癌 TN分期 环周切缘 

分 类 号：R735.37[医药卫生—肿瘤]