磁共振成像檢查對直腸癌淋巴結轉移的診斷價值

王炫欽　李國柱

[關鍵詞] MRI檢查;直腸癌;淋巴結轉移;診斷;靈敏度;特異度

[中圖分類號] R445.2? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）22-0128-03

Diagnostic value of magnetic resonance imaging in lymph node metastasis of rectal cancer

WANG Xuanqin? ?LI Guozhu

Department of Radiology， Dingxi People's Hospital， Dingxi? ?743000， China

[Abstract] Objective To explore the sensitivity and specificity of magnetic resonance imaging （MRI） in diagnosing lymph node metastasis of rectal cancer. Methods A total of 100 patients with rectal cancer from December 2017 to December 2020 in the oncology department of our hospital were randomly selected as research cases. All the included patients were examined by MRI and CT， and the clinical pathological diagnosis results were used as the gold standard to analyze MRI. The diagnostic value of MRI for disease staging and the sensitivity and specificity of diagnosis of rectal cancer lymph node metastasis were analyzed. And the diagnosis rate of MRI and CT was compared. Results The clinical diagnosis results showed that among 100 patients， 30 were NO， 40 were N1， and 30 were N2. MRI showed that 29 were NO， 42 were N1， and 29 were N2. The diagnosis accuracy of disease staging was 98.00% （98/100）. It can be seen from the clinical diagnosis results that a total of 71 patients with lymph node metastasis were included in the 100 patients. The diameter of the lymph node was 4.34～15.75 mm， with an average of （9.37±2.19） mm. 66 cases were diagnosed by MRI， the sensitivity was 92.96% （66/71）， the specificity was 100.00% （29/29）， the Kappa value was 0.72， and the consistency was good. Compared with CT examination， the diagnosis rate of MRI examination was higher （P<0.05）. Conclusion The application of MRI in the diagnosis of rectal cancer lymph node metastasis has a high diagnosis rate， sensitivity， and specificity， which can effectively reflect the severity of the patient's condition， provide a scientific basis for clinical diagnosis and treatment， and is worthy of promotion.

[Key words] MRI; Rectal cancer; Lymph node metastasis; Diagnosis; Sensitivity; Specificity

直腸癌是人體消化系統常見病，指發生于人體齒狀線至直腸乙狀結腸交界處之間的惡性腫瘤，多見于中老年人群，且男性發生率更高[1]。研究提示，淋巴結轉移是直腸癌患者腫瘤進展常見途徑，可影響患者肝臟、肺部、骨等組織，提高治療難度，降低了治療后生存率[2]。因此，診斷直腸癌患者淋巴結轉移意義重大，以此制定針對性的手術方案，聯合預后評估，可有效提高治療效果。磁共振成像（magnetic resonance imaging，MRI）是臨床常見影像學檢查技術之一，具有分辨率高、可多方位成像等優點，諸多研究認可其對直腸癌淋巴結轉移診斷具有極高的應用價值，利于直腸癌患者診治工作[3-4]。本文選取2017年12月至2020年12月本院腫瘤科接收直腸癌患者100例作為研究病例，探究MRI檢查診斷直腸癌淋巴結轉移的靈敏度、特異度，現報道如下。