摘要
目的探讨动态对比增强磁共振成像(DCE-MRI)联合扩散加权成像(DWI)对直肠癌临床分期的评估价值。方法回顾性分析2019年6月至2022年6月于南阳市第一人民医院经手术病理检查确诊的70例直肠癌患者的临床资料,所有患者入院时均接受DCE-MRI及DWI检查,以手术病理结果为金标准,分析DCE-MRI联合DWI检查对直肠癌患者术前肿瘤侵犯程度T分期、区域淋巴结转移N期的诊断价值。结果70例直肠癌患者病理检查结果显示,T1期12例(17.14%),T2期15例(21.43%),T3期34例(48.57%),T4期9例(12.86%);N0期36例(51.43%),N1期23例(32.86%),N2期11例(15.71%)。以手术病理结果为金标准,DCE-MRI联合DWI检查直肠癌术前肿瘤T分期诊断总符合率为95.71%(67/70),对直肠癌术前肿瘤N分期诊断的总符合率为87.14%(61/70)。经Kappa一致性度量,DCE-MRI联合DWI检查直肠癌术前肿瘤侵犯程度的结果与手术病理检查结果的一致性较好(Kappa=0.94,P<0.001),检查直肠癌术前区域淋巴结转移结果与手术病理检查结果的一致性较好(Kappa=0.81,P<0.001)。结论DCE-MRI联合DWI检查对直肠癌患者临床分期有较好的诊断价值,且其评估术前肿瘤侵犯程度及区域淋巴结转移结果与手术病理检查结果的一致性较好。
Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion-weighted imaging(DWI)on clinical staging of rectal cancer.Methods The clinical data of 70 patients with rectal cancer confirmed by surgery and pathological examination in Nanyang First People’s Hospital from June 2019 to June 2022 were retrospectively analyzed.All patients received DCE-MRI and DWI examination at admission.Taking the surgical pathological results as the gold standard,the diagnostic value of DCE-MRI combined with DWI examination for preoperative T-stage of tumor invasion and N-stage of regional lymph node metastasis in patients with rectal cancer was analyzed.Results The pathological examination results of 70 patients with rectal cancer showed that there were 12 cases(17.14%)in T1 stage,15 cases(21.43%)in T2 stage,34 cases(48.57%)in T3 stage,and 9 cases(12.86%)in T4 stage;moreover,there were 36 cases(51.43%)in N0 stage,23 cases(32.86%)in N1 stage and 11 cases(15.71%)in N2 stage.Taking the pathological results of surgery as the gold standard,the total coincidence rate of DCE-MRI combined with DWI in the diagnosis of preoperative tumor T staging of rectal cancer was 95.71%(67/70),and the total coincidence rate of preoperative tumor N staging of rectal cancer was 87.14%(61/70).According to Kappa consistency measure,the results of DCE-MRI combined with DWI in detecting the degree of preoperative tumor invasion of rectal cancer were in good agreement with the results of surgical pathology(Kappa=0.94,P<0.001).The results of preoperative regional lymph node metastasis of rectal cancer were consistent with those of surgical pathology(Kappa=0.81,P<0.001).Conclusions DCE-MRI combined with DWI has better diagnostic value for clinical staging of rectal cancer,and it is consistent with the surgical pathology in evaluation of preoperative tumor invasion and regional lymph node metastasis.
作者
王可
李波
范海磊
曾华珺
Wang Ke;Li Bo;Fan Hailei;Zeng Huajun(Magnetic Resonance Imaging Room,Nanyang First People’s Hospital,Nanyang 473000,China)
出处
《中国实用医刊》
2022年第21期82-85,共4页
Chinese Journal of Practical Medicine
关键词
直肠癌
磁共振成像
动态对比增强磁共振成像
扩散加权成像
肿瘤分期
Rectal neoplasms
Magnetic resonance imaging
Dynamic contrast enhanced magnetic resonance imaging
Diffusion weighted imaging
Tumor staging
