摘要
目的 分析直肠癌淋巴结转移诊断中高分辨率盆腔磁共振(MRI)扫描的应用价值.方法 选取2020年3月至2023年3月收治的81例直肠癌患者,回顾性分析临床资料,以病理学诊断结果将81例患者分为转移组(淋巴结转移)与未转移组(淋巴结未转移),分别为57例、24例.入组者均行盆腔MRI检查,对比2组MRI参数,以病理诊断结果为金标准,将MRI检查结果与病理诊断结果进行比较,分析高分辨率盆腔MRI对直肠癌分期的诊断效能.结果 转移组表观弥散系数(ADC)值、长径、Ktrans、Kep水平较未转移组更低,短径、Ve值较未转移组更高(P＜0.05);MRI对转移组T1-2期的诊断准确度、灵敏度、特异度、阳性预测值及阴性预测值分别为 89％、88％、91％、88％、91％;T3 期分别为 89％、88％、91％、88％、91％;T4期分别为 100％、100％、100％、100％、100％;N0期分别为 63％、66％、61％、63％、59％;N1-2分别为 63％、39％、66％、63％、68％.结论 直肠癌淋巴结转移诊断中高分辨率盆腔MRI的应用价值较高,可准确判断淋巴结转移情况,以指导临床诊治.
Abstract
Objective To analyze the application value of high-resolution pelvic magnetic resonance imaging(MRI)scanning in the diagnosis of lymph node metastasis of rectal cancer.Methods Eighty-one rectal cancer patients admitted from March 2020 to March 2023 were selected to retrospectively analyze the clinical data,and the 81 patients were divided into the metastatic group(lymph node metastasis)and the non-metastatic group(lymph node not metastasized)with the results of pathological diagnosis,which were 57 cases and 24 cases,respectively.All the enrolled patients underwent pelvic MRI examination,and the MRI parameters of the two groups were compared.Taking the pathological diagnosis results as the gold standard,the MRI examination results with the pathological diagnosis results were compared and the diagnostic efficacy of high-resolution pelvic MRI on the staging of rectal cancer was analyzed.Results The apparent diffusion coefficient(ADC)value,long diameter,Ktrans,and Kep levels were lower in the metastasis group than those in the non-metastasis group,and the short diameter and Ve values were higher than those in the non-metastasis group(P＜0.05).The diagnostic accuracies,sensitivities,specificities,positive predictive values,and negative predictive values of MRI for T1-2 stage in the metastasis group were 89％,88％,91％,88％,and 91％,respectively;for T3 were 89％,88％,91％,88％,and 91％,respectively;for T4 were 100％,100％,100％,100％,and 100％,respectively;for N0 were 63％,66％,61％,63％,and 59％,respectively;forN1-2were 63％,39％,66％,63％,68％,respectively.Conclusion The application value of high-resolution pelvic MRI in the diagnosis of lymph node metastasis of rectal cancer is high,and it can accurately determine the lymph node metastasis to guide clinical diagnosis and treatment.
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