容蓉,孙晓伟,王霄英,蒋学祥.MRT2加权成像与增强CT对原发直肠癌术前T分期诊断的比较[J].中国医学影像技术,2011,27(6):1213~1217
MRT2加权成像与增强CT对原发直肠癌术前T分期诊断的比较
Diagnostic value of MR T2WI and contrast enhanced CT in the pre-operative T staging of primary rectal carcinoma
投稿时间:2011-01-13  修订日期:2011-03-11
DOI:
中文关键词:  直肠肿瘤  磁共振成像  体层摄影术,X线计算机  肿瘤分期  诊断效能
英文关键词:Rectal neoplasms  Magnetic resonance imaging  Tomography, X-ray computed  Neoplasm staging  Diagnostic efficacy
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作者单位E-mail
容蓉 北京大学前沿交叉学科研究院功能成像中心,北京 100871
北京大学第一医院医学影像科,北京 100034 
 
孙晓伟 北京大学第一医院医学影像科,北京 100034  
王霄英 北京大学第一医院医学影像科,北京 100034
北京大学前沿交叉学科研究院功能成像中心,北京 100871 
cjr.wangxiaoying@vip.163.com 
蒋学祥 北京大学第一医院医学影像科,北京 100034  
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中文摘要:
       目的 比较MR T2WI和增强CT对原发直肠癌术前T分期的诊断效能。方法 51例经活检病理证实的原发直肠腺癌,术前其中27例接受常规MR检查,43例接受CT检查,19例接受MR和CT检查。用MR T2WI和增强CT图像对肿瘤浸润深度进行判断,并与术后病理结果对照。结果 MR T2WI对直肠癌术前T分期与术后病理的一致性优于增强CT(Kappa值0.72 vs 0.52,P<0.05),对原发直肠癌T1/T2和T3/T4分期准确率高于增强CT(88.89% vs 79.07%);MR T2WI鉴别T1/T2、T3/T4期肿瘤的特异度(94.74% vs 81.25%)、阳性预测值(85.71% vs 57.14%)均优于增强CT。MR T2WI对T1/T2和T3/T4期肿瘤的分期效能优于CT。结论 MR T2WI在原发直肠癌术前T分期评价中的效能优于增强CT。
英文摘要:
      Objective To evaluate the diagnostic efficacy of pre-operative MR T2WI and contrast enhanced CT T staging of primary rectal cancer. Methods Fifty-one patients with primary rectal cancer were selected prospectively. Totally 27 patients underwent conventional MR and 43 patients underwent CT scan. Nineteen patients underwent both MR and CT scan. T2WI and contrast enhanced CT were used to determine T staging, respectively. Radical resection of rectal carcinoma was performed in all patients. Post-operative histopathological results were taken as reference. Results The concordance of T2WI preoperative T staging with postoperative pathology was better than that of contrast enhanced CT (Kappa value: 0.72 vs 0.52, P<0.05). MR T2WI was superior to contrast enhanced CT in the differentiation between T1/T2 tumor and T3/T4 tumor (accuracy: 88.89% vs 79.07%; specificity: 94.74% vs 81.25%; positive predictive value: 85.71% vs 57.14%). ROC showed that the diagnostic efficacy of MR T2WI preoperative T staging was superior to that of contrast enhanced CT. Conclusion MR T2WI is more accurate than contrast enhanced CT in local T staging of rectal cancer, especially in assessment of T1/T2 and T3/T4 tumors.
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