灌肠护理后磁共振对直肠癌病人临床分型的判断价值分析

摘要

Objective:to study the diagnostic value of magnetic resonance imaging(MRI) in the clinical classification of patients with rectal cancer after enema nursing.Methods:A total of 32 cases of rectal cancer patients admitted to our hospital from January 2016 to August 2017 were enrolled as the experimental group,and another 32 cases of non-rectal cancer patients admitted to our hospital in the same period were enrolled as the control group.Conducting MRI on all patients in the condition with enema and non-enema,and comparing the results of before and after the enema.At the same time,the diagnose results of MRI on preoperative staging,the presence of lymph node metastasis,and side cut edge of rectal cancer patients were observed after the enema.Resuits:the sensitivity,specific degrees,and accuracy of MRI in the diagnosis of rectal cancer in patients after enema were 100.00％ (32/32),87.50％ (28/32),and 93.75％ (60/64),respectively;which were significant higher than those of MRI before enema,sensitiving 65.63％ (21/32),specific degrees 62.50％ (20/32),and accuracy 64.06％ (41/64).The results were statistically significant(P＜0.05).After enema,the accuracy of MRI in the diagnosis of rectal cancer in T1-T2 was 81.82 ％ (9/11),85.71％ (12/14) for T3,and 85.71％ (6/7) for T4;the overall accuracy was 84.38 ％ (27/32),of which including 1 case underestimated,and 4 cases overestimated.The sensitivity of MRI in the diagnosis of rectal lymph node metastasis was 78.95％(15/19),the specificity was 69.23％ (9/13) and the accuracy was 75.00％ (24/32).The sensitivity of the MRI in the diagnosis of side incisions was 88.89％ (8/9),the specificity was 95.65 ％ (22/23),and the accuracy was 93.75 ％ (30/32).Conclusions:After enema nursing,the results of MRI in the diagnosis of rectal cancer patients had a high value.It was helpful for preoperative staging,diagnose the condition of lymph node metastasis in a certain degree,and would effectively determine the sid ecut edge infringement.%[目的]研究灌肠护理后磁共振(MRI)对直肠癌病人临床分型的判断价值.[方法]选取2016年1月-2017年8月我院收治的直肠癌病人32例为研究对象,另取同期我院收治的非直肠癌病人32例为对照.分别于未灌肠状态下以及灌肠状态下对所有研究对象进行MRI检测,并比较灌肠前后MRI对直肠癌病人的检出情况,同时观察灌肠后MRI对直肠癌病人术前分期、有无淋巴结转移以及侧切缘侵犯的诊断情况.[结果]灌肠后MRI诊断直肠癌的敏感度、特异度以及准确度分别为100.00％(32/32)、87.50％(28/32)、93.75％(60/64),均明显高于灌肠前MRI的65.63％(21/32)、62.50％(20/32)、64.06％(41/64),组间比较有统计学意义(均P＜0.05).灌肠后MRI诊断直肠癌T1—T2期的准确度为81.82％(9/11),诊断直肠癌T3期的准确度为85.71％(12/14),诊断直肠癌T4期的准确度为85.71％(6/7),总体准确度为84.38％(27/32),其中低估肿瘤分期1例,高估肿瘤分期4例.灌肠后MRI诊断直肠癌淋巴结转移的敏感度为78.95％(15/19)、特异度为69.23％(9/13)、准确度为75.00％(24/32).灌肠后MRI诊断侧切缘侵犯的敏感度为88.89％(8/9)、特异度为95.65％(22/23)、准确度为93.75％(30/32).[结论]灌肠后MRI检查对直肠癌病人具有较高的诊断价值,有利于术前分期,且可在一定程度上诊断直肠癌病人淋巴结转移情况,同时可有效确定侧切缘侵犯情况.