MRI在直肠癌术前N分期中的应用价值研究

目的：分析直肠癌直肠系膜内淋巴结的MRJ表现，评价MRI在直肠癌术前N分期中的应用价值。方法：对2011年8月至2012年2月经手术治疗并经病理证实的116例直肠癌病例行术前MRI检查，观察和记录每个淋巴结的大小、边缘以及信号，以病理学诊断转移淋巴结阳性为标准进行分组，由2位影像科医生采用双盲法阅片并达成一致。结果：MRI诊断直肠周围淋巴结转移的各项诊断标准具有统计学意义，其中淋巴结短轴直径与转移相关性的统计结果为（P〈0．05，r=0．210），淋巴结边缘与转移相关性的统计结果为（P〈0．05，r=0．180），淋巴结信号与转移相关性的统计结果为（P〈0．05，r=0．209）。Logistic回归分析显示淋巴结大小诊断淋巴结转移的可信度最高，Wals值为13．180。结论：综合分析直肠周围淋巴结大小，边缘、信号对诊断淋巴结转移有较大作用，其中以淋巴结大小的作用最为显著。

The Application Value of MRI in N Staging of Rectal Cancer Pre-operation

Objective： To analyze the results of mesorectum node in MRI images, and evaluate the application value of MRl in N Staging of rectal cancer pre-operation. Methods： One hundred and thirty-six pathology-proven patients who had undergone total mesorectal excision （TME） for rectal carcinoma were enrolled in this study after preoperative MRI examination. The short-axis diameter, margin and signal of each node were observed and recorded. Patients were assigned to the benign node or malignant node group according to pathological analysis of node samples. Images were reviewed blindly and made the consensus by 2 professional doctors. Results： The short-axis diameters, margin, signal of LN within the mesorectum showed significant correlation with the lymph node metastasis（P〈0.05）. The correlation coefficients of lymph node metastasis with short-axis diameters, margin, signal of LN were respectively 0.210, 0.180, 0.209 （P 〈0.05）. The logistic regression analysis showed that the credibility of short-axis diameters was highest （Wals = 13.180）. Cxrnclusion： It was probably helpful to improve the diagnosis of mesorectal lymph node metastases by considering the size, margin, signal of the lymph nodes, especially the short-axis diameters.