高分辨磁共振成像在局部晚期直肠癌术前 T 分期评估中的价值分析

临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (3): 60-.

高分辨磁共振成像在局部晚期直肠癌术前 T 分期评估中的价值分析

1. 呼和浩特市中医蒙医医院影像科，内蒙古呼和浩特 010000；2. 呼和浩特市第一医院影像科，内蒙古呼和浩特 010000

出版日期:2025-07-01 发布日期:2025-11-20

Value analysis of high-resolution magnetic resonance imaging in preoperative T staging evaluation of locally advanced rectal cancer

1.Imaging Department of Hohhot Hospital of Traditional Chinese Medicine and Mongolian Medicine, Inner Mongolia Hohhot 010000, China; 2.Imaging Department of Hohhot First Hospital, Inner Mongolia Hohhot 010000, China

Online:2025-07-01 Published:2025-11-20

摘要/Abstract

摘要：

目的探究高分辨磁共振成像 (magnetic resonance imaging,MRI) 在局部晚期直肠癌术前 T 分期评估中的敏感度。方法纳入 2024 年 2 月至 2025 年 1 月在呼和浩特市第一医院进行术前高分辨 MRI 检查的 86 例局部晚期直肠癌患者，比较术前高分辨 MRI 判定的 T 分期与术后病理结果的一致性，计算高分辨MRI 术前评估直肠癌 T 分期的敏感度、特异度、准确率、阳性预测率、阴性预测率以及 Kappa 值评估高分辨 MRI 诊断 T 分期的准确性与一致性，绘制受试者操作特征 (receiver operating characteristic,ROC) 曲线并计算曲线下面积 (area under curve,AUC)。结果 86 例局部晚期直肠癌患者中，高分辨 MRI 与病理分期一致者有 76 例，总体诊断准确率为 88.37%，Kappa 值为 0.842，显示与术后病理的高度一致；高分辨 MRI在 T3 期的诊断敏感度最高（92.86%），但特异度相对较低（80.00%）；T4 期敏感度为 82.61%，特异度为95.24%，准确率为 91.86%；T1 ～ 2 期的特异度达 98.73%，准确率为 96.51%；ROC 曲线分析显示，MRI 诊断 T1 ～ 2 期、T3 期及 T4 期的 AUC 分别为 0.851、0.865 和 0.889。结论高分辨 MRI 在局部晚期直肠癌术前 T 分期评估中具有良好的诊断效能，尤其在 T3 期和 T4 期的识别中表现出较高的敏感度与准确性。

关键词: 高分辨, 磁共振成像, 晚期直肠癌, T 分期

Abstract:

Objective To explore the sensitivity of high-resolution magnetic resonance imaging (MRI) in the preoperative T staging assessment of locally advanced rectal cancer. Method A total of 86 patients with locally advanced rectal cancer who underwent preoperative high-resolution MRI staging at the First Hospital of Hohhot from February 2024 to January 2025 were included and compared with the postoperative pathological results. The sensitivity, specificity rate, accuracy rate, positive predictive rate, negative predictive rate and Kappa value were calculated to evaluate the accuracy and consistency of high-resolution MRI in diagnosing T staging. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated. Result Among the 86 patients with locally advanced rectal cancer, 76 cases had the same high-resolution MRI and pathological stage. The overall diagnostic accuracy rate was 88.37%, and the Kappa value was 0.842, showing a high degree of consistency with the postoperative pathology. High-resolution MRI had the highest diagnostic sensitivity (92.86%) in stage T3, but its specificity was relatively low (80.00%). The sensitivity of stage T4 was 82.61%, the specificity was 95.24%, and the accuracy rate was 91.86%. The specificity of stage T1~2 reached 98.73% and the accuracy rate was 96.51%. ROC curve analysis showed that the AUC of MRI in diagnosing T1~2 stage, T3 stage and T4 stage was 0.851, 0.865 and 0.889 respectively, all of which had high discriminative ability. Conclusion High-resolution MRI has good diagnostic efficacy in the preoperative T staging assessment of locally advanced rectal cancer, especially showing high sensitivity and accuracy in the identifi cation of T3 and T4 stages.

Key words: High-resolution, Magnetic resonance imaging, Advanced rectal cancer, T staging

翁红雨 , 郭飞 . 高分辨磁共振成像在局部晚期直肠癌术前 T 分期评估中的价值分析 [J]. 临床普外科电子杂志, 2025, 13(3): 60-.

Weng Hongyu, Guo Fei. Value analysis of high-resolution magnetic resonance imaging in preoperative T staging evaluation of locally advanced rectal cancer [J]. Journal of General Surgery for Clinicians, 2025, 13(3): 60-.