【摘要】 目的探讨磁共振(MRI)、多层螺旋CT(MSCT)、经直肠超声(TRUS)在直肠癌术前分期评价上的临床应用价值。方法选择经手术治疗的直肠癌患者47例。所有患者在术前联合进行MRI、MSCT、TRUS检查。检查后分别单独依据MRI、MSCT、TRUS以及综合各种影像学方法对直肠癌进行影像学T分期和N分期,并与手术病理分期对照。结果术前MRI、TRUS和MSCT的T分期准确度分别为87.23%(41/47)、76.60%(36/47)和78.72%(37/47),Kappa值分别为0.776、0.600和0.590(P均<0.001);术前MRI、TRUS和MSCT的N分期准确度分别为65.96%(31/47)、59.57%(28/47)和57.45%(27/47),Kappa值分别为0.453、0.361和0.352(P均<0.001)。依据影像学方法综合评价直肠癌T分期和N分期的准确度分别为91.49%(43/47)和72.34%(34/47)。结论 MRI、MSCT、TRUS在直肠癌术前分期上,具有突出的临床应用价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of magnetic resonance imaging(MRI),multi-slice spiral computed tomography(MSCT)and transrectal ultrasound(TRUS)in preoperative staging of rectal carcinoma.Method 47 patients with pathologically confirmed rectal carcinoma were detected by both MRI,MSCT and TRUS before surgery.The preoperative T staging and N stage of rectal carcinoma were performed by MRI,MSCT,TRUS respectively or by all of synthetically images.The preoperative staging results were compared with those of postoperative pathological staging.Results The preoperative T staging of rectal carcinoma was 87.23%(kappa=0.776,P<0.001)by MRI, 76.60%(kappa=0.600,P<0.001)by TRUS, 78.72%(kappa=0.590,P<0.001)by MSCT, respectively.The preoperative N staging of rectal carcinoma was 65.96%(kappa=0.453, P<0.001)by MRI,59.57%(kappa=0.361, P<0.001)by TRUS,57.45%(kappa=0.352, P<0.001)by MSCT,respectively.The preoperative T staging of rectal carcinoma was 91.49%(P<0.001)by all of synthetically images.The preoperative N staging of rectal carcinoma was 72.34%(P<0.001)by all of synthetically images.Conclusion It was useful to appreciate the preoperative staging of rectal carcinoma by MRI,MSCT and TRUS.更多还原