Radiology Institute, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant'Andrea Hospital, Rome 00189, Italy. ; Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant'Andrea Hospital, Rome 00189, Italy.
Department of Surgical and Medical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University of Rome, Sapienza, Sant'Andrea Hospital, Rome 00189, Italy.
Korean J Radiol. 2014 Jan-Feb;15(1):37-44. doi: 10.3348/kjr.2014.15.1.37. Epub 2014 Jan 8.
To evaluate the accuracy of magnetic resonance imaging (MRI) with lumen distention for rectal cancer staging and circumferential resection margin (CRM) involvement prediction.
Seventy-three patients with primary rectal cancer underwent high-resolution MRI with a phased-array coil performed using 60-80 mL room air rectal distention, 1-3 weeks before surgery. MRI results were compared to postoperative histopathological findings. The overall MRI T staging accuracy was calculated. CRM involvement prediction and the N staging, the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were assessed for each T stage. The agreement between MRI and histological results was assessed using weighted-kappa statistics.
The overall MRI accuracy for T staging was 93.6% (k = 0.85). The accuracy, sensitivity, specificity, PPV and NPV for each T stage were as follows: 91.8%, 86.2%, 95.5%, 92.6% and 91.3% for the group ≤ T2; 90.4%, 94.6%, 86.1%, 87.5% and 94% for T3; 98,6%, 85.7%, 100%, 100% and 98.5% for T4, respectively. The predictive CRM accuracy was 94.5% (k = 0.86); the sensitivity, specificity, PPV and NPV were 89.5%, 96.3%, 89.5%, and 96.3% respectively. The N staging accuracy was 68.49% (k = 0.4).
MRI performed with rectal lumen distention has proved to be an effective technique both for rectal cancer staging and involved CRM predicting.
评估磁共振成像（MRI）联合直肠腔内充气对直肠癌分期和环周切缘（CRM）受累预测的准确性。
73 例原发性直肠癌患者在术前 1-3 周内行直肠腔内充气（使用 60-80mL 空气）高分辨率 MRI 检查，采用相控阵线圈。将 MRI 结果与术后组织病理学结果进行比较。计算总体 MRI T 分期准确性。评估各 T 分期时 CRM 受累预测及 N 分期的准确性、敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。采用加权 Kappa 统计评估 MRI 与组织学结果之间的一致性。
MRI 对 T 分期的总体准确性为 93.6%（k = 0.85）。各 T 分期的准确性、敏感度、特异度、PPV 和 NPV 如下：T2 及以下组为 91.8%、86.2%、95.5%、92.6%和 91.3%；T3 组为 90.4%、94.6%、86.1%、87.5%和 94%；T4 组为 98.6%、85.7%、100%、100%和 98.5%。预测 CRM 准确性为 94.5%（k = 0.86）；敏感度、特异度、PPV 和 NPV 分别为 89.5%、96.3%、89.5%和 96.3%。N 分期准确性为 68.49%（k = 0.4）。
直肠腔内充气的 MRI 检查已被证明是一种有效的直肠癌分期和预测 CRM 受累的技术。
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