3.0 T高分辨磁共振在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值

摘要 目的：研究3.0 T高分辨磁共振（MRI）在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值。方法：将我院从2018年1月～2019年12月收治的直肠癌患者120例纳入研究。所有患者均接受3.0 T高分辨MRI检查，以术后病理结果为金标准，分析其对术前T N分期、环周切缘有无累及淋巴结转移的评估价值。结果：直肠癌术前3.0 T高分辨MRI T分期与病理结果一致性较高，检验结果显示Kappa值=0.543，P值=0.000。直肠癌术前3.0 T高分辨MRI N分期与病理结果一致性较高，检验结果显示Kappa值=0.519，P值=0.000。以术后病理结果为金标准，直肠癌术前3.0 T高分辨MRI诊断环周切缘累及的灵敏度、特异度、准确度、阴性预测值、阳性预测值分别为92.50%（37/40）、93.75%（75/80）、93.33%（112/120）、96.15%（75/78）、88.10%（37/42）。直肠癌淋巴结转移者MRI边缘模糊、肠周围脂肪信号不均匀占比较无淋巴结转移者更高，且短径较无淋巴结转移者更长（均P＜0.05）。结论：3.0 T高分辨MRI在直肠癌术前T N分期、环周切缘有无累及淋巴结转移的评估价值较高，具有一定的临床应用价值。

The Evaluation Value of 3.0T High Resolution Magnetic Resonance Imaging in Preoperative T N Staging, Peripheral Resection Margin Involvement with or without Lymph Node Metastasis of Rectal Cancer

ABSTRACT Objective: To study the evaluation value of 3.0T high resolution magnetic resonance (MRI) in preoperative T N staging, peripheral resection margin involvement with or without lymph node metastasis of rectal cancer. Methods: 120 rectal cancer patients in our hospital from January 2018 to December 2019 were included in the study. All patients received 3.0T high resolution MRI examination, and the postoperative pathological results were used as the gold standard, and its evaluation value for preoperative T N staging and peripheral resection margin with or without lymph node metastasis were analyzed. Results: Preoperative 3.0T high resolution MRI T staging of rectal cancer was highly consistent with the pathological results. Test results showed that Kappa value =0.543, P value =0.000. Preoperative 3.0T high resolution MRI N staging of rectal cancer was highly consistent with the pathological results. Test results showed that Kappa value =0.519, P value =0.000. With postoperative pathological results as the gold standard, the sensitivity, specificity, accuracy, negative predictive value and positive predictive value of preoperative 3.0T high resolution MRI diagnosis of peripheral resection margin involvement were 92.50% (37/40), 93.75% (75/80), 93.33% (112/120), 96.15% (75/78) and 88.10% (37/42), respectively. The proportion of patients with MRI signs with fuzzy margins and uneven intestinal fat signal were higher than those without lymph node metastasis, and the short diameter was longer than that of patients without lymph node metastasis (all P<0.05). Conclusion: 3.0T high resolution MRI has a high evaluation value in preoperative T N staging, peripheral resection margin involvement with or without lymph node metastasis of rectal cancer, which has a certain clinical application value.