高分辨磁共振成像增强在术前直肠肿瘤TNM分期中的研究  

Application value of high-resolution MRI enhanced examination in TNM staging of preoperative rectal tumor

作　　者：蒋加行 林芝葑 黄松涛 Jiang Jiahang;Lin Zhifeng;Huang Songtao(Department of Radiology,Guang’an People’s Hospital,Guangan 638000,China)

机构地区：[1]广安市人民医院放射科,广安638000

出　　处：《中国医学装备》2024年第9期60-64,共5页China Medical Equipment

基　　金：四川省卫生健康委员会科研课题(20PJ310)。

摘　　要：目的:探究直肠肿瘤术前高分辨磁共振成像(MRI)增强检查在术前直肠肿瘤淋巴转移(TNM)分期诊断中的应用价值。方法:选取2021年6月至2022年9月期间广安市人民医院收治的80例直肠肿瘤患者,术前均接受高分辨MRI增强检查,并经术后病理检查确诊,分析MRI增强检查的T分期、N分期及其与术后病理分期结果的一致性。结果:术后病理分期结果显示,80例患者中,T_(1)期14例、T_(2)期29例、T_(3)期25例、T_(4)期12例;N_(0)期28例、N_(1)期33例、N_(2)期19例。高分辨MRI常规与增强检查T分期诊断准确率为86.25%(69/80),N分期诊断准确率为90.00%(72/80),与术后病理分期结果对比具有高度一致性(Kappa=0.806、0.847,P<0.05)。术前80例患者经高分辨MRI检出转移性淋巴结与术后病理符合率为88.75%(71/80),分析发现转移性淋巴结多集中于直径为0.8~1.0 cm范围内,占66.41%。随着N分期、T分期增加,肿瘤感兴趣区(ROI)的容量转移常数(K^(trans))依次增加,转移性淋巴结K^(trans)明显高于非转移性淋巴结,差异有统计学意义(t=14.890,P<0.05)。结论:术前高分辨MRI常规与增强检查与直肠肿瘤术后病理TN分期具有高度一致性,完善高分辨MRI增强检查有助于评估患者肿瘤进展情况及确定治疗方案。Objective:To explore the application value of preoperative high-resolution magnetic resonance imaging(MRI)enhanced examination in the preoperative diagnosis of tumor node metastases(TNM)staging of rectal tumor.Methods:A total of 80 patients with rectal tumor admitted to Guang’an People’s Hospital from June 2021 to September 2022 were selected.All patients underwent high-resolution MRI enhanced examinations before surgery and they were confirmed by postoperative pathological examination.The consistency of MRI T staging,N staging and postoperatively pathological staging results was analyzed.Results:The postoperative pathological staging results showed that 14 cases were at T_(1) stage,and 29 cases were at T_(2) stage,and 25 cases were at T_(3) stage,and 12 cases were at T_(4) stage,and 28 cases were at N_(0) stage,and 33 cases were at N_(1) stage and 19 were at N_(2) stage in the 80 patients.The diagnostic accuracies of T staging and N staging of high-resolution MRI routine and enhanced examinations were respectively 86.25%(69/80)and 90.00%(72/80)(Kappa=0.806,0.847,P<0.05).The consistency rate between preoperative high-resolution MRI detection and postoperative pathology for metastatic lymph nodes of 80 patients was 88.75%(71/80).The analysis found that metastatic lymph nodes mostly concentrated in the diameter range of 0.8-1.0 cm,accounting for 66.41%.With the increasing of N staging and T staging,the volume transfer constant(Ktrans)of the region of interest(ROI)of tumor increased successively.The Ktrans value of metastatic lymph nodes was significantly higher than that of non-metastatic lymph nodes,and the difference was statistically significant(t=14.890,P<0.05).Conclusion:Preoperative high-resolution MRI routine and enhanced examination has highly consistency with postoperative pathological TN staging of rectal tumor.The improvement of high-resolution MRI enhanced examination is helpful to assess the progression of patients’tumors and to determine treatment plans for them.

关 键 词：高分辨磁共振成像(MRI) 增强检查 直肠肿瘤 肿瘤淋巴转移(TNM)分期 

分 类 号：R445.2[医药卫生—影像医学与核医学]