高分辨率MRI与MDCT诊断直肠系膜淋巴结转移价值比较

doi:10.3969/j.issn.1006-6233.2022.09.032

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摘要 目的: 研究高分辨率MRI与MDCT诊断直肠系膜淋巴结转移价值。方法: 选取2018年3月至2021年12月来我院通过病理活检确诊的147例直肠癌患者信息进行回顾性研究,均采用高分辨率MRI与MDCT诊断。分析MDCT、MRI各项参数情况。以受试者特征曲线(ROC曲线)以及图片比较MDCT、MRI诊断效能。分析MDCTT分期与病理诊断分期、MRIT分期与病理诊断分期的一致性。结果: 转移组SUV(2.25±0.76)、短长径之比(0.86±0.14)、淋巴结数(7.88±1.45)个、淋巴结大小(0.67±0.12)cm均要高于未转移组[分别为1.26±0.34、0.74±0.13、(3.56±1.57)个、(0.51±0.13)cm],差异有统计学意义(P<0.05)。转移组ADC(0.81±0.11)10^-3mm²/s低于未转移组(1.02±0.16)10^-3mm²/s,有统计学意义(P<0.05),而肠周脂肪混杂信号征76(87.4%)、浆膜面浸润77(88.5%)、静脉包绕征77(88.5%)均高于未转移组[分别为2(3.3%)、2(3.3%)、11(18.3%)],差异有统计学意义(P<0.05)。MDCT、MRI的AUC分别为0.887、0.877,差异无统计学意义(Z=-1.000,P=0.317),敏感度分别为0.839、0.850差异无统计学意义(χ²=2.000,P=0.157)、特异性分别为0.983、0.839,差异无统计学意义(χ²=2.000,P=0.157)。MDCT、MRI分别与病理诊断分期的一致性Kappa值为0.873、0.863,有强的一致性。结论: 高分辨率MRI与MDCT均可诊断直肠癌直肠系膜淋巴结转移,具有较高的诊断效能,适用于临床。

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	杜竑兵
	敬杰
	李海青

关键词 ： MRI, MDCT, 直肠癌直肠系膜淋巴结转移, 诊断价值

Abstract：Objective: To study the value of high-resolution MRI and MDCT in the diagnosis of rectal mesorectal lymph node metastasis. Methods: From March 2018 to December 2021, 147 patients with rectal cancer diagnosed by pathological biopsy in our hospital were selected for a retrospective study, all of whom were diagnosed by high-resolution MRI and MDCT. The parameters of MDCT and MRI were analyzed. The innovation of this study is to compare the diagnostic efficiency of MDCT and MRI with the receiver characteristic curve (ROC curve) and pictures, to improve the diagnostic efficiency, and to provide a visual comparison of the diagnostic efficiency, which provides practical value for the diagnosis of mesorectal lymph node metastasis. The receiver characteristic curve (ROC curve) and pictures were used to compare the diagnostic performance of MDCT and MRI. The consistency between MDCTT staging and pathological diagnosis staging, MRIT staging, and pathological diagnosis staging were analyzed. Results: The SUV (2.25±0.76), the ratio of short to long diameter (0.86±0.14), the number of lymph nodes (7.88±1.45), and the size of lymph nodes (0.67±0.12) cm in the metastasis group were higher than those in the non-metastatic group [1.26 ±0.34, 0.74±0.13, (3.56±1.57), (0.51±0.13) cm]; the difference was statistically significant (P<0.05). The ADC (0.81±0.11) 10-3mm2/s in the metastatic group was lower than the non-metastasis group (1.02±0.16) 10-3mm²/s, which was statistically significant (P<0.05), while the periintestinal fat mixed signal sign [76 (87.4 %)], serous surface infiltration [77 (88.5%)], and venous wrapping sign [77 (88.5%)] were higher than those in the non-metastatic group [respectively 2 (3.3%), 2 (3.3%), 11 ( 18.3%)]; the difference was statistically significant (P<0.05). The AUC of MDCT and MRI were 0.887 and 0.877, respectively, and the difference was not statistically significant (Z=-1.000, P=0.317). The sensitivity was 0.839 and 0.850, respectively, and the difference was not statistically significant (χ²=2.000, P=0.157). The sexes were 0.983 and 0.839, respectively, and the difference was not statistically significant (χ²=2.000, P=0.157). The Kappa values of MDCT and MRI were 0.873 and 0.863, respectively, and the consistency of pathological diagnosis and staging showed strong consistency. Conclusion: Both high-resolution MRI and MDCT can diagnose rectal cancer mesorectal lymph node metastasis, which have high diagnostic efficiency and are suitable for clinical use.

Key words： MRI MDCT Rectal cancer mesorectal lymph node metastasis Diagnostic value

基金资助:四川省医学科研课题计划项目,(编号:S20189)

引用本文:

杜竑兵, 敬杰, 李海青. 高分辨率MRI与MDCT诊断直肠系膜淋巴结转移价值比较[J]. 河北医学, 2022, 28(9): 1560-1563.
DU Hongbing, JING Jie, LI Haiqing. Comparison of the Value of High-Resolution MRI and MDCT in the Diagnosis of Rectal Mesenteric Lymph Node Metastases. HeBei Med, 2022, 28(9): 1560-1563.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.09.032 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I9/1560

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