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目的以病理分期作为金标准,探讨薄层MRI联合MR扩散加权成像(DWI)对直肠癌术前局部分期的价值。资料与方法对首诊直肠癌的40例患者进行前瞻性研究。40例均行常规MRI、薄层MRI和DWI后手术治疗并行病理分期。结果薄层MRI较常规MRI能更好地显示肠壁的各层解剖结构及肿瘤对肠壁及邻近结构的侵犯范围和程度。常规MRI、薄层MRI联合DWI两种检查方法行TN分期的准确性分别为45%和67.5%,差异有统计学意义(P=0.044);T分期的准确性分别为65%和85%,差异有统计学意义(P=0.040);N分期的准确性分别为65%和75%,差异无统计学意义(P=0.332)。结论薄层MRI联合DWI在直肠癌术前局部分期(TN分期)方面优于常规MRI,特别是在T分期方面,薄层MRI联合DWI更具优势,准确性提高到85%;在N分期方面,薄层MRI联合DWI与常规MRI相比无明显差别。
Objective To evaluate the value of thin-layer MRI combined with MR diffusion-weighted imaging (DWI) in the preoperative staging of rectal cancer using the pathological staging as the gold standard. Materials and Methods Forty patients undergoing primary rectal cancer were prospectively studied. Forty patients underwent routine MRI, thin-layer MRI and DWI after operation for pathological staging. Results Compared with conventional MRI, thin-layer MRI can better display the anatomical structure of each layer of the intestinal wall and the extent and degree of tumor invasion to the intestinal wall and adjacent structures. The accuracy of TN staging was 45% and 67.5% respectively by conventional MRI, thin layer MRI combined with DWI, the difference was statistically significant (P = 0.044); the accuracy of T staging was 65% and 85% respectively, The difference was statistically significant (P = 0.040). The accuracy of N staging was 65% and 75%, respectively, with no significant difference (P = 0.332). Conclusion The combination of thin-section MRI and DWI is better than conventional MRI in preoperative TNM staging. Especially for T staging, thin-layer MRI combined with DWI has more advantages and the accuracy is improved to 85%. In terms of N staging Compared with conventional MRI, thin-layer MRI and DWI showed no significant difference.