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目的比较经直肠超声(ERUS)和体部线圈MRI对直肠癌T分期诊断准确性。方法回顾性分析31例术前未接受新辅助放化疗的直肠癌患者,对所有患者均于术前1周行ERUS和MR检查、后行一期手术切除。以术后病理结果作为金标准,比较ERUS和MRI对直肠癌T分期的诊断效能。结果 31例患者中,术后病理诊断T1期7例,T2期6例,T3期18例。ERUS显示病变累及肠管长度约(28.18±13.30)mm,MRI显示约为(35.58±18.24)mm,二者差异有统计学意义(t=3.497,P=0.002),但两种检查所测得病变下缘距肛门距离、病灶厚度的差异均无统计学意义(P均>0.05)。ERUS诊断直肠癌T1、T2、T3、T4期的准确率分别为93.55%,93.55%,87.10%和100%,总准确率为93.55%;MRI诊断直肠癌T1、T2、T3、T4期的准确率分别为87.10%,70.97%,64.52%和93.55%,总准确率为79.03%;ERUS、MRI诊断的直肠癌各期以及总准确率的差异均无统计学意义(P均>0.05)。结论 ERUS和MRI均为直肠癌术前分期诊断的可靠检查方法,ERUS对于T分期的准确性稍高于MRI。
Objective To compare the diagnostic accuracy of T staging of rectal cancer with transrectal ultrasound (ERUS) and body coil MRI. Methods Retrospective analysis of 31 cases of rectal cancer patients who had not received neoadjuvant chemoradiation before operation were performed. All patients underwent ERUS and MR examinations one week before surgery. To postoperative pathological results as the gold standard, ERUS and MRI compared the diagnostic efficiency of T staging of rectal cancer. Results Among the 31 patients, 7 were diagnosed as T1 in stage, 6 in T2 and 18 in T3. ERUS showed that the length of intestine involved in the lesion was (28.18 ± 13.30) mm and MRI was (35.58 ± 18.24) mm, the difference was statistically significant (t = 3.497, P = 0.002) There was no significant difference in the distance between the lower edge and the anus and lesion thickness (all P> 0.05). The accuracy of ERUS in diagnosing rectal cancer was 93.55%, 93.55%, 87.10% and 100%, respectively, with a total accuracy of 93.55%. The accuracy of MRI in diagnosing rectal cancer at T1, T2, T3 and T4 The total accuracy rate was 87.10%, 70.97%, 64.52% and 93.55%, respectively, with a total accuracy of 79.03%. There was no significant difference in the accuracy of ERUS and MRI in the diagnosis of rectal cancer (P> 0.05). Conclusion Both ERUS and MRI are reliable methods for the preoperative staging of rectal cancer. The accuracy of ERUS for T staging is slightly higher than that of MRI.