MRT2WI和增强CT对原发直肠癌术前T分期的诊断效能研究

摘要

目的 探讨直肠癌患者术前采用MR T2 WI和增强CT检查对术前T分期的临床诊断意义.方法 对我院收治的114例原发性直肠癌患者进行研究,按随机数字表法分为两组各57例.其中57例患者术前给予MR T2 WI检查作为MR组,另57例患者术前给予增强CT检查作为CT组.观察两组患者T分期情况,分析两种检查方式对不同分期原发直肠癌的诊断作用,探讨MR和CT对原发性直肠癌的诊断价值.结果 MR诊断原发直肠癌TNM分期与病理诊断TNM分期对比无差异,P>0.05.CT诊断原发直肠癌TNM分期与病理诊断TNM分期对比无差异,P>0.05.MR对原发直肠癌TNM分期诊断阳性率与病理诊断无差异,P>0.05.CT对原发直肠癌TNM分期诊断阳性率与病理诊断无差异,P>0.05.MR对原发直肠癌TNM分期诊断的阳性预测值上明显高于CT诊断,P<0.05;而在敏感度、特异度、阴性预测值及准确率上并无差异,P>0.05.结论 MR T2 WI对原发直肠癌患者术前TNM分期的诊断效能优于增强CT,尤其在对阳性的预测上较好,值得临床应用及推广.%Objective To study the clinical diagnostic value of preoperative T staging in patients with rectal cancer by MR T2 WI and enhanced CT .Methods The clinical data of 114 patients with primary rectal cancer admitted from January 2014 to January 2016 in our hospital were studied ,they were randomly divided into two groups (n=57).Among them, 57 patients were given preoperative MR T 2 WI as the MR group ,and the other 57 patients were given enhanced CT before surgery as the CT group . Two groups were observed in patients with T staging , diagnosis and analyzed the effects of two kinds of inspection methods for dif -ferent stages of primary colorectal cancer , evaluated the diagnostic value of MR and CT in primary rectal cancer .Results There was no difference between MR diagnosis of primary rectal cancer TNM staging and pathological diagnosis of TNM staging , P >0.05.CT diagnosis of primary rectal cancer TNM staging and pathological diagnosis of TNM staging had no difference , P >0.05. The positive rate of TNM in the diagnosis of MR staging of primary rectal cancer was not different from that of pathological diagno -sis, P >0.05.The positive rate of TNM in the diagnosis of CT staging of primary rectal cancer was not different from that of path -ological diagnosis, P >0.05.The positive predictive value of MR in the diagnosis of TNM staging of primary rectal cancer was significantly higher than that of CT , P <0.05; However, there was no difference in sensitivity , specificity,negative predictive value and accuracy rate , P >0.05.Conclusion MR T2 WI is better than CT in the preoperative TNM staging of primary rectal cancer patients ,especially in the positive prediction ,which is worthy of clinical application and promotion .