摘要
目的 探讨多模态磁共振成像(MRI)联合超声内镜(EUS)应用于食管癌术前T分期诊断的价值.方法 将我院2021年1月至2023年1月期间70例行食管癌手术患者作为研究对象,同时予以多模态MRI、EUS和二者联合检查,对比3种检查方式对食管癌术前T分期的诊断准确性.结果 根据金标准显示,70例食管癌患者病理学分期:T1期8例、T2期14例、T3期40例、T4期8例;EUS检查诊断T1期6例、T2期12例、T3期27例、T4期5例,结果准确率71％(50/70),与病理一致性(kappa值=0.56,P＜0.001);多模式MRI检查诊断T1期6例、T2期12例、T3期33例、T4期7例,结果准确率83％(58/70),与病理一致性(kappa值=0.73,P＜0.001);多模式MRI检查联合EUS诊断T1期8例、T2期13例、T3期33例、T4期8例,结果准确率89％(62/70),与病理一致性(kappa值=0.82,P＜0.001);多模态MRI联合EUS检查一致性高于多模态MRI检查与EUS检查,多模态MRI检查高于EUS检查(P＜0.001).结论 多模式MRI检查联合EUS检查可显著提高食管癌术前T分期的诊断准确性,值得临床推广.
Abstract
Objective To explore the value of multi-mode Magnetic Resonance Imaging(MRI)combined with Endoscopic ultrasound(EUS)in the preoperative T-stage diagnosis of esophageal cancer.Methods Seventy patients undergoing surgery for esophageal cancer in our hospital from January 2021 to January 2023 were selected as the study subjects,and multimodal MRI,EUS,and combined examination were performed at the same time to compare the diagnostic accuracy of the three methods for preoperative T staging of esophageal cancer.Results According to the gold standard,the pathological stages of 70 patients with esophageal cancer were T1(8 cases),T2(14 cases),T3(40 cases)and T4(8 cases).EUS was used to diagnose 6 patients with stage T1,12 patients with stage T2,27 patients with stage T3,and 5 patients with stage T4.The accuracy of EUS was 71％(50/70),which was consistent with pathology(kappa=0.56,P＜0.001).The results showed that 6 cases in the T1 stage,12 cases in the T2 stage,33 cases in the T3 stage,and 7 cases in T4 stage were diagnosed by multi-modal MRI,and the accuracy rate was 83％(58/70),which was consistent with the pathology(kappa=0.73,P＜0.001).Multimodal MRI combined with EUS diagnosed 8 cases in T1 stage,13 cases in T2 stage,33 cases in T3 stage,and 8 cases in T4 stage.The accuracy of the results was 89％(62/70),which was consistent with the pathology(kappa=0.82,P＜0.001).The consistency of multimodal MRI combined with EUS was higher than that of multimodal MRI and EUS,and that of multimodal MRI was higher than that of EUS(P＜0.001).Conclusion Multi-modal MRI combined with EUS can significantly improve the diagnostic accuracy of preoperative T staging of esophageal cancer,which is worthy of clinical promotion.
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