The Research Of CT、MRI And TRUS For Preperative T Staging In The Mid-Low Rectal Cancer

Objective:The determination of the treatment scheme and prognosis of rectal cancer was closely related to preoperative staging.This study intends to explore the magnetic resonance imaging (MRI) and transrectal ultrasound (TRUS) and multi-slice spiral CT (MSCT) in the preoperative T staging of mid-low rectal cancer to evaluate the clinical application value and the best mode.Methods:The Clinical data of 413 cases with rectal cancer patients confirmed by Postoperative pathology in the First Affiliated Hospital of Guangxi Medical University from January 2013 to January 2015 was analyzed retrospectively. We analysisd the differences of the basic accuracy and complete accuracy in 3 kinds of examinations by comparing the radiological T staging with postoperative pathological T staging. The data was analysised by statistical software SPSS 17.0 processing.Results:413 cases were Included, male 234 cases, female 179 cases, age 18-85 years old, average 54.45+10.47 years old; the complete accuracy of MRI, TRUS and CT was respectively 62.71%(185/295),59.70%(120/201) and 48.12% (128/266), there were no significant difference of MRI and TRUS, and both of them were higher than CT, the difference was statistically significant (P< 0.05); It was different of the accuracy of different stages in the 3 kinds of examinations. In T3-4 stage, the basic accuracy was not different of MRI (82.74%) and TRUS (83.55%), and were higher than CT 72.12%(P< 0.05); In T1-2 stage, the basic accuracy of TRUS was 73.47%, which was the highest of the three kinds of examin ations, the difference was statistically significant (P< 0.05). In T1-2 stage, the basic accuracy of MRI+CT and TRUS+CT was respectively 52.63%(20/38) and 84.62%(22/26), the difference was statistically significant (P< 0.05)Conclusion:The distinction of CT is poorer, so it is poor value of diagnosis for preoperative T staging in mid-low rectal cancer. But it is higher value of the judgment of T4 and distant metastasis. It is the same to distinguish the T3-4 which need preoperative neoadjuvant chemoradiation between MRI and TRUS. While TRUS is the best examination to distinguish the T1 or T2. In the further study, The mode of CT combined with TRUS for mid-low rectal cancer in preoperative T staging evaluation has the advantages of simple operation, high accuracy, popularization, is worthy of promotion.