| ObjectiveTo evaluate the accuracy,sensitivity and specificity of magnetic resonance imaging(MRI)and CT in preoperative T staging of rectal cancer,and to investigate the application value of preoperative T stage of rectal cancer with MRI.MethodsRetrospective study was conducted in patients with rectal cancer from January 2010 to December 2014 in the Department of general surgery,the General Hospital of Henan Ping Mei Shen Ma medical group.The study was conducted in 427 patients with rectal cancer confirmed by surgical resection and pathology.Meet the inclusion criteria of 105 patients,among which 69 patients were male and 36 pateients were female.The average age of patients was(59.30 + 9.73)years.All patients underwented CT and MRI examination before operation.The name,age,pathological diagnosis,operation methods,T stage with CT,T stage with MRI,and other general information were recored in detail,and the correlation between CT T stage,MRI T stage and pathologic T stage were compared.The application value of preoperative T stage of rectal cancer with MRI was study.Results1)49 cases were pathological T1-T2 stage,of which 35 cases was detected with CT,14 cases were not detected,and 5 patients of T3 period were mistaken for T1-T2.37 cases were pathological T3 stage,of which 30 patients were detected with CT,7 patients were detected,and 2 patients of T4 stage were mistaken for T3 stage.19 cases were pathological T4 stage,of which 17 patients were detected with CT,2 patients were not detected,and 2patients of T3 stage were mistaken for T4 stage.The overall accuracy rate of CT in evaluating pathologic T stage was 78.10%.The kappa value of CT T stage and T stage was0.655,which had good consistency(p<0.01).The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of CT in evaluating pathologicT1-T2 stage were 71.43%,91.07%,87.50%,78.46%,81.90% and 0.813,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of CT in evaluating pathologic T3 stage were 81.08%,76.47%,65.22%,88.14%,78.10% and 0.788,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of CT in evaluating pathologic T4 stage were 89.47%,97.67%,89.47%,97.67%,96.19% and 0.936,respectively.2)16 cases were pathological T1 stage,of which 15 cases were detected with MRI,1patients was not detected,and 2 patients of T2 were mistaken for T1 stage.33 cases were pathological T2 stage,of which 28 patients were detected with MRI,2 patients were mistaken for T1 stage,and 3 patients were mistaken for T3 stage.37 patients were pathological T3 stage,of which 4 patients were mistaken for T2 stage,1 patient was mistaken for T4 stage.19 patients were pathological T4 stage,of which 18 patients were detected with MRI,1 patients were mistaken for T3 stage.The overall accuracy rate of MRI in evaluating pathologic T staging was 88.57%.The kappa value of MRI T stage and T stage was 0.842,which had good consistency(p < 0.01).The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of MRI in evaluating pathologic T1 stage were 93.75%,97.75%,88.24%,98.86%,97.14% and 0.958.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of MRI in evaluating pathologic T2 stage were 84.85%,93.06%,84.85%,93.06%,90.48% and 0.890.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of MRI in evaluating pathologic T3 stage were86.49%,94.12%,88.89%,92.75%,91.43% and 0.903.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of MRI in evaluating pathologic T4 stage were 94.74%,98.84%,94.74%?98.84%,98.10% and 0.968.The sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and AUC of MRI in evaluating pathologic T1-T2 stage were 93.88%,92.86%,92.00%,94.55%,93.33% and 0.934.3)The kappa value of CT T stage and T stage was 0.655,which had good consistency.The kappa value of MRI T stage and T stage was 0.842,which had good consistency.The consistency of MRI T stage and T stage was better than that of CT.The AUC of CT and MRI in evaluating pathologic T1-T2 stage were 0.813 and 0.934,respectively,which had statistical difference(Z=3.858,p<0.01).The AUC of CT and MRI in evaluating pathologic T3 stage were 0.788 and 0.903,which had statistical difference(Z=3.848,p<0.01).The AUC of CT and MRI in evaluating pathologic T4 stage were 0.936 and 0.968,which had no statistical difference(Z=1.192,p>0.05).4)The total accuracy rate of CT and MRI in evaluating pathologic T stage were78.10%(82/105)and 88.57%(93/105),and the total accuracy rate of MRI was higher than that of CT with statistical difference(?2=4.149,p=0.042).Conclusion:The value of MRI in evaluating preoperative T stage of rectal cancer was better than that of CT,and the evaluation of MRI inpreoperative T stage has good consistency with pathologic T stage,which can provide reference to determine the surgical treatment and formulate a comprehensive treatment plan for rectal cancer. |
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