摘要
目的探讨直肠腔内超声与MRI三维重建在直肠癌术前分期及环周切缘评估中的应用。方法回顾性分析2017年1月至2019年12月菏泽医学专科学校附属医院收治的104例行直肠癌根治术的直肠癌患者的临床资料,患者术前均行ERUS和MRI三维重建检查对,以术后病理学检测结果作为“金标准”,对比ERUS和MRI三维重建检查对临床分期及CRM检查的准确率。结果ERUS检查对T_(1)、T_(2)、T_(3)、T_(4)分期的诊断准确率分别为100.00%、82.86%、85.29%、88.46%,总准确率为86.54%(90/104);MRI三维重建检查对T_(1)、T_(2)、T_(3)、T_(4)分期的诊断准确率分别为88.89%、65.71%、70.59%、88.46%,总准确率为75.00%(78/104)。经比较,ERUS检查对T分期的诊断准确率明显高于MRI三维重建检查(χ^(2)=4.457,P=0.035)。ERUS检查对N_(0)、N_(1)、N_(2)分期的诊断准确率分别为67.80%、59.38%、69.23%,总准确率为65.38%(68/104);MRI三维重建检查对N_(0)、N_(1)、N_(2)分期的诊断准确率分别为81.36%、71.88%、76.92%,总准确率为77.88%(81/104)。经比较,ERUS检查对N分期的诊断准确率明显低于MRI三维重建检查(χ^(2)=3.999,P=0.046)。ERUS检查对直肠癌CRM阳性诊断的灵敏度、特异度、准确率分别为86.76%、75.00%、82.69%;MRI三维重建检查的灵敏度、特异度、准确率分别为95.45%、86.84%、92.31%。经比较,MRI三维重建检查对直肠癌CRM阳性诊断的准确率明显高于ERUS检查(χ^(2)=4.396,P=0.036)。结论ERUS在判断直肠癌患者术前T分期方面较MRI三维重建更具优势,但MRI更有利于帮助评估患者的淋巴结分期及CRM阳性情况,二种检查方式均对临床评估患者情况有重要价值。
Objective To explore the application of endorectal ultrasound(ERUS)and MRI three-dimensional reconstruction in preoperative staging of rectal cancer and evaluation of circumferential resection margin(CRM).Methods A retrospective analysis was performed on the clinical data of 104 patients with rectal cancer who underwent radical resection of rectal cancer and were admitted to Afficated Hospital of Heze Medical College from January 2017 to December 2019 was retrospectively analyzed.All underwent ERUS and MRI three-dimensional reconstruction examination before surgery.Considering postoperative pathology as the golden standard,accuracy rates of ERUS and MRI three-dimensional reconstruction for clinical staging and CRM examination were compared.Results The diagnostic accuracy rates of ERUS examination for stage T_(1),T_(2),T_(3),and T_(4) were 100.00%,82.86%,85.29%,and 88.46%,respectively.Furthermore,the total accuracy rate was 86.54%(90/104).The diagnostic accuracy rates of MRI three-dimensional reconstruction examination for stage T_(1),T_(2),T_(3),and T_(4) were 88.89%,65.71%,70.59%,and 88.46%.Moreover,the total accuracy rate was 75.00%(78/104).The diagnostic accuracy rate of ERUS examination was significantly higher than that of MRI three-dimensional reconstruction examination for T staging(χ^(2)=4.457,P=0.035).The diagnostic accuracy rates of ERUS for stage N_(0) ,N_(1) ,and N_(2) were 67.80%,59.38%,and 69.23%.The total accuracy rate was 65.38%(68/104).The diagnostic accuracy rate of MRI three-dimensional reconstruction for stage N_(0) ,N_(1) ,and N_(2) was 81.36%,71.88%,and 76.92%.The total accuracy rate was 77.88%(81/104).The diagnostic accuracy rate of the ERUS examination was significantly lower than that of the MRI three-dimensional reconstruction examination for N staging(χ^(2)=3.999,P=0.046).The sensitivity,specificity,and accuracy of ERUS and MRI three-dimensional reconstruction for positive CRM of rectal cancer were(86.76%,75.00%,82.69%)and(95.45%86.84%,92.31%),respectively.The diagnostic accuracy rate of MRI three-dimensional reconstruction examination was significantly higher than that of ERUS examination for positive CRM of rectal cancer(χ^(2)=4.396,P=0.036).Conclusion ERUS is more advantageous than MRI three-dimensional reconstruction in determining the preoperative T staging of rectal cancer patients.However,MRI is more conducive to assessing lymph node staging and CRM positive status.Both examination methods are of great value for the clinical assessment of patients.
作者
宋玉娟
SONG Yu-juan(Heze Medical College/Department of Ultrasound,Affiliated Hospital of Heze Medical College,Heze 274007,Shandong Province,China)
出处
《中国CT和MRI杂志》
2021年第9期141-143,共3页
Chinese Journal of CT and MRI
关键词
直肠癌
直肠腔内超声
MRI三维重建
术前分期
环周切缘评估
Rectal Cancer
Endorectal Ultrasound
MRI Three-dimensional Reconstruction
Preoperative Staging
Circumferential Resection Margin Evaluation
作者简介
第一作者/通讯作者:宋玉娟,女,讲师、主治医师,主要研究方向:超声诊断和教学。E-mail:kjio985@163.com。
