摘要
目的探讨T_(2)WI评分系统结合增强序列对直肠癌壁外血管侵犯(extramural vascular invasion,EMVI)的诊断价值。方法选取直肠癌根治术前行MRI检查的直肠癌患者155例影像学资料,由2位阅片者判读T_(2)WI图像EMVI评分,评分0~1分为EMVI阴性,评分3~4分为EMVI阳性,评分2分者结合增强后有无明确充盈缺损判读EMVI状态,以术后病理结果为“金标准”,分别计算2位阅片者对直肠癌EMVI的诊断价值。采用χ^(2)检验分析数据。结果术后病理结果显示46例患者存在EMVI。2位阅片者判读T_(2)WI图像EMVI评分的加权Kappa值为0.728(95%CI:0.645~0.812)。T_(2)WI评分系统结合增强序列诊断EMVI的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为52.17%(24/46)、97.25%(106/109)、88.89%(24/27)、82.81%(106/128)、83.87%(130/155)。结论T_(2)WI评分系统结合增强序列诊断直肠癌EMVI的灵敏度中等,特异性较高。
Objective To investigate the diagnostic value of high-resolution T_(2)WI scoring system combined with enhanced sequence for extramural vascular invasion(EMVI) in rectal cancer. Methods 155 rectal cancer patients who underwent high-resolution MR examination before radical resection were retrospectively enrolled. Two radiologists combined the enhanced sequence to interpret the EMVI score on the high-resolution T_(2)WI image. Score 0~1 was judged as EMVI negative, score 3~4 was judged as EMVI positive and score 2 was distinguished by recognizing whether or not a filling defect wass present in the vessel. Based on postoperative pathological results as the "gold standard", the value of high-resolution MR scoring system combined with enhanced sequence in the diagnosis of EMVI of rectal cancer was calculated. χ^(2) test was used for data analysis. Results Postoperative pathological results showed that 46 patients had EMVI. The weighted kappa value of two radiologists who interpreted the EMVI score on the high-resolution MR image was 0.728(95%CI: 0.645 to 0.812).The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the diagnosis of EMVI with the high-resolution MR scoring system combined with enhanced sequence were 52.17%(24/46), 97.25%(106/109), 88.89%(24/27), 82.81%(106/128), was 83.87%(130/155) repectively. Conclusion The high-resolution MR scoring system combined with enhanced sequence in the diagnosis of EMVI in rectal cancer has medium sensitivity and high specificity.
作者
杨彦松
沈月红
张益飞
李月玥
郑桂华
YANG Yansong;SHEN Yuehong;ZHANG Yifei;LI Yueyue;ZHENG Guihua(Department of Radiology,Afiliated Tumor Hospital of Nantong University,Nantong 226361,China;Department of Pathology,Afiliated Tumor Hospital of Nantong University,Nantong 226361,China)
出处
《医学影像学杂志》
2023年第5期809-812,共4页
Journal of Medical Imaging
基金
江苏省南通市卫生健康委员会科研课题项目(编号:MA2020007)
南通大学临床医学研究专项项目(编号:2019LQ014)。
关键词
直肠肿瘤
壁外血管侵犯
磁共振成像
Rectal cancer
Extramural vascular invasion
Magnetic resonance imaging
