Study Of Preoperative Staging Of Rectal Cancer And Hemodynamics By Transrectal Ultrasound

Objective:To explore the relationship between rectal internal artery hemodynamic changes and staging of rectal cancer and in order to improve the accuracy of preoperative staging of rectal cancer.Methods:In 240 cases confirmed by enteroscope biopsy and pathology in patients with rectal cancer, preoperative TRUS examination。 Observation of tumor size, internal echo, the relationship between the depth of tumor invasion and the surrounding tissues and organs。 Measure the cancer internal artery PSV, EDV, PI, RI, evaluate the ultrasound staging of rectal cancer, and compared with postoperative pathologic staging control. According to the different pathological stages were grouped on hemodynamic parameters. Another 25 patients with normal TRUS examination and detect hemodynamic parameters of the rectal wall artery. As the normal control group.And all the results were statistically analyzed.Results:1, endorectal ultrasound assessment of rectal cancer T staging the total coincidence rate was 83.3% (200/240). The sensitivity of T1 to T4 are respectively 80%,78.5%,84.3%,87.8% and the specificity were 100%,73.9%, 89.5%,81.1%; the Kappa value is 0.738. Ultrasonic staging and pathological staging highly consistent (P=0.000), to evaluate the sensitivity of the lymph node metastasis is 71.6%, the specificity is 78%, the total coincidence rate is 72.9%.2, hemodynamic parameters: ① The cardiac artery pulsatility index PI mean: 1.31 ± 0.27, where no statistically significant difference between the normal group and the T1 group (P>0.05), there was statistical significance in normal group and T2, T3, T4 (P<0.05), the difference was stati stically significant differences between T1, T2, T3, T4 group (P<0.05);② The resistance index of RI mean value is 0.65 ± 0.07, which had statistical significance in normal group and T1, T2, T3, T4 group differences (P<0.05), no statistically significant differences between T1 and T2, T3 and T4 group (P<0.05), T1 were significant, respectively T3, T4 and T2 between group differences (P<0.05);③ The mean peak systolic flow velocity of PSV was 18.15 ± 9.09cm/s, which had statistical significance in normal group and T1, T2, T3, T4 groups (P<0.05), no statistically significant differences between T1 and T2, T3 and T4 group (P<0.05), T1 were significant, respectively T3, T4 and T2 between group differences (P<0.05);④ Shuzhang blood flow velocity mean 5.64 ± 2.96cm/s, The statistical significance of normal group and T1, T2, T3, T4 groups (P<0.05), no statistically significant differences between T1 and T2, T3 and T4 group (P<0.05), T1 were significant, respectively T3, T4 and T2 between group differences (P<0.05).3, The PI was negatively correlated with pathologic stage (r=-0.680, P =0.000), RI was negatively correlated with pathologic stage (r=-0.470, P=0.000) and pathological stage was positively correlated (r=0.200, P=0.000), EDV and pathological stage was positively correlated(r=0.289, P=0.000).Conclusion:The accuracy of endorectal ultrasonography has higher diagnostic for rectal cancer, tumor internal artery hemodynamic parameters and rectal cancer staging of relevance, is helpful to improve the accuracy of preoperative staging of rectal cancer.