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时间:2020-06-04
《直肠癌高分辨率磁共振成像T分期与病理T分期的对照研究.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、中华外科杂志2012年3月第5O卷第3期ChinJSurg,March2012,Vo1.50,No.3.结直肠恶性肿瘤.直肠癌高分辨率磁共振成像T分期与病理T分期的对照研究孙应实李晓婷张晓燕唐磊崔雳张晓鹏【摘要】目的探讨高分辨率MRI对直肠癌T分期的诊断价值。方法回顾2005年1月至2008年12月245例经病理证实的直肠癌患者,行术前MRI检查。根据直肠癌局部浸润的高分辨率MRI征象做出分期诊断,并与术后病理组织学肿瘤T分期进行对照研究。结果MRIT分期准确率为83.7%(205/245)。MRI和病理T分期的一致性较好(K=0.693,95%C/:0.611~0.776)。97例患者接
2、受术前放疗和(或)化疗,新辅助治疗后MR1分期与病理T分期的一致率为73.2%(71/97,K=0.563,95%C/:0.428—0.698)。直接手术患者148例,MR1分期与病理T分期的一致率为90.5%(134/148,K:0.794,95%CI:0.692~0.896)。肿瘤病理分期与肠管周径侵犯程度中度相关(P=0.619,P<0.01)。结论高分辨率MRI对于直肠癌T分期有着较高的诊断准确性,有助于制定合理的治疗方案。对于术前接受新辅助放化疗病例在手术前应重新做MR1分期。肠管周径侵犯程度的评价对MRI直肠癌T分期诊断有一定的帮助。【关键词】直肠肿瘤;肿瘤分期;磁共振成像;病
3、理学,外科Preoperativestagingofrectalcarcinomawithhigh-resolutionMRI:correlationwithhistopathoiogicfindingsSUN一shi,LIXiao—ting,ZHANGXiao—yah,TANGLei,CUI,ZHANGXiao-peng.DepartmentofRadiologyandKeyLabofCarcinogenesisandTranslationalResearchforMinistryofEducation,PekingUniversityCancerHospital&Institute,B
4、eijing100142,ChinaCorrespondingauthor:ZHANGXiao-peng,Email:zxp@Ⅱnceorg【Abstract】0bjectiveToassessthecorrelationofpreoperativehigh—resolution-MR1withhistopathologicfindingsintumorstagingofrectalcarcinoma.MethodsFromJanuary2005toDecember2008,245casesofpathologicallyconfirmedrectalcancer,whoreceivedp
5、reoperativescanbya1.5Thigh—resolution—MR1wereincludedinthisretrospectivestudy.Toextracteimagesignsfromhigh·resolutionMRI,andmadeadiagnosisfortumorstagingclassification.Assessmentfordiagnosticaccuracyofhigh—resolutionMR1wasmadewithcomparisonofhistopathologicalclassfication.ResultsTheoveralldiagnost
6、icaccuracy0fT—stagewas83.7%(205/245).Theconsistencycoeficient(K)betweentheMRIandhistopathologicT—stagewas0.693(95%CI:0.611-0.776),whichwasconsideredgood.Forthe97caseswithpreoperativechemoradiotherapy,theagreementratebetweenthepost—chemoradiotherapyMRIandhistopathologicT—stagewas73.2%(71/97,K=0.563
7、,95%CI:0.428-0.698).Forthe148caseswithoutpreoperativechemoradiotherapy,theagreementratebetweentheMRIandhistopathologicT—stagewas90.5%(134/148,K=0.794,95%C/:0.692-0.896).ThehistopathologicT—stageanddiameterinfring
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