比较MSCT与MRI在结直肠癌术前分期诊断中的价值

摘要

Objective To evaluate the diagnositic value of the MSCT and MRI in preoperative staging of colorectal carcinoma in comparison with pathological findings.Methods Totally 53 patients with histopathologically proven colorectal carcinoma were included.Plain and contrast scanning were performed with a row CT scanner and a 1.5 Tesla Simens Avanto unit.Results The sensitivity of MR for T1-2 was superior to MSCT (P＜0.05), but the difference was not statistically significant for T3, T4 stages (P＞0.05).The overall accuracy of MSCT, routine MRI and DWI in the definition of the involved lymph node was 56.60％, 58.49％ and 73.58％, respectively.DWI had medium relationship with pathologic results, Kappa value was 13.927 (P=0.001).No statistical relationship of MSCT, routine MRI and pathologic results was found (Kappa= 1.128, P=0.288; Kappa = 1.585, P=0.208).Conclusion MRI is better than MSCT in preoperative staging of colorectal carcinoma.DWl is more accurately than MSCT and routine MRI for definition of the involved lymph node in patients with colorectal carcinoma.%目的 结合术后病理结果比较MSCT与MRI在结直肠癌术前分期诊断中的价值.方法 对经手术病理证实的结直肠癌患者53例,分别进行MSCT和MR平扫、增强扫描.结果 MR对T1-2分期的敏感度明显高于MSCT(P＜0.05);MRI对T3、T4分期的敏感度与MSCT相比差异无统计学意义(P＞0.05).MSCT、常规MRI和DWI三种扫描方法诊断淋巴结分期的准确率分别为56.60%、58.49%、73.58%.DWI的敏感度及阴性预测值最高,分别为92.31%和88.24%,与组织病理结果具有中等相关性,Kappa值为13.927(P=0.001).MSCT和常规MRI诊断结果与组织病理结果无相关性,Kappa值分别为1.128(P=0.288)和1.585(P=0.208).结论 在结直肠癌T分期方面.MRI较MSCT具有一定优势;DWI能更准确地预测结直肠癌区域淋巴结转移情况.