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[目的]探讨高分辨率MRI(HR-MRI)对直肠癌术前病理分期评估的应用价值.[方法]选择2012年7月至2013年1月间经病理检查确诊为直肠癌的患者50例,术前均给行HR-MRI检查观察肿瘤浸润深度及淋巴结转移情况,根据HR-MRI检查结果进行TNM分期.全部患者均给行全直肠系膜切除术,比较术前HR-MRI与术后病理检查的TNM分期结果.采用Kappa检验评价术前HR-MRI与术后病理TNM分期结果的一致性;采用配对t检验评估直肠癌下端与肛缘的距离.[结果]T分期结果显示,50例直肠癌患者HR-MRI的诊断准确性为88%(44/50),T1-2期为90%(45/50),T3期为88%(44/50),T4期为98%(49/50),HR-MRI与病理T分期结果具有较好的一致性(P<0.001);N分期结果显示,HR-MRI判断直肠癌总的诊断准确性为80%,N0期为80%(40/50),N1期为68%(34/50),N2期为84%(42/50),HR-MRI与病理N分期结果具有中度一致性(P<0.001).术前HR-MRI对直肠癌病灶最下端至肛缘距离的测量结果与术后测量结果比较差异无统计学意义(P>0.05).[结论]HR-MRI对直肠癌术前病理分期评估具有临床应用价值.
[Objective] To investigate the value of high-resolution MRI (HR-MRI) in the preoperative staging of rectal cancer. [Methods] Fifty patients with pathologically confirmed rectal cancer between July 2012 and January 2013 were enrolled in this study. , Preoperative HR-MRI examination of tumor invasion depth and lymph node metastasis, according to the results of HR-MRI TNM staging.All patients underwent total mesorectal excision, compared with preoperative HR-MRI and postoperative pathology The TNM staging was used to assess the consistency between preoperative HR-MRI and postoperative pathological TNM staging by using Kappa test. The paired t-test was used to evaluate the distance between the lower rectum and anal verge. [Results] T staging showed that 50 cases The diagnostic accuracy of HR-MRI in rectal cancer patients was 88% (44/50), 90% (45/50) in T1-2, 88% (44/50) in T3 and 98% in T4 / 50). The results of N-staging showed that the accuracy of HR-MRI in the diagnosis of rectal cancer was 80% and that in stage N0 was 80% (P <0.001) 40/50), 68% (34/50) in stage N1, 84% (42/50) in stage N2, and moderate consistency between HR-MRI and pathological N stage (P <0.001) MRI of rectal cancer lesions from the bottom to the anal margin of the distance measurement results There was no significant difference in the postoperative measurement results (P> 0.05). [Conclusion] HR-MRI has clinical value in the preoperative staging evaluation of rectal cancer.