Kocaman Orhan, Baysal Birol, Şentürk Hakan, İnce Ali Tüzün, Müslümanoğlu Mahmut, Kocakoç Ercan, Arıcı Sema, Uysal Ömer, Yıldız Kemal, Türkdoğan Kürşat, Danalıoğlu Ahmet
Department of Gastroenterology, Bezmialem University Faculty of Medicine, İstanbul, Turkey.
Turk J Gastroenterol. 2014 Dec;25(6):669-73. doi: 10.5152/tjg.2014.6214.
BACKGROUND/AIMS: To retrospectively compare the efficacy of multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and endosonography (EUS) in the staging of rectal carcinoma.
A total of 50 patients (36 male, 14 female) were included in the study. The data from surgical staging were used as reference for comparing the yield of EUS, MRI, and MDCT in preoperative T and N staging of rectal carcinoma. Comparisons were based on the chi-square test.
The mean age+SD of the patients were 60±12 years (range; 28-80). The distribution of rectal tumors according to the T and N staging in surgical pathology was as following: T1 (n:2), T2 (n:15), T3 (n:22), T4 (n:11); N0 (n:22), N1-2 (n:28). The accuracy rate of EUS was statistically higher than that of MDCT (92% vs 64%; p<0.01) and that of MRI (92% vs 72%; p<0.01) for T2 tumors. For T3 tumors, EUS had statistically better accuracy of staging compared to MDCT (90% vs 58%; p<0.01) and MRI (90% vs 60%; p<0.01). As for T4 tumors, the accuracy rate of EUS was higher compared to MRI (98% vs 80%; p<0.01). There was no statistical difference in accuracy rates for detection of lymph nodes across the modalities (EUS, 84%; MDCT 76%; MRI 70%; p=not significant).
EUS appears more accurate in T staging compared to MDCT and MRI in rectal carcinoma. Regarding nodal staging, performance of EUS, MDCT and MRI are similar.
背景/目的:回顾性比较多排螺旋计算机断层扫描(MDCT)、磁共振成像(MRI)和内镜超声检查(EUS)在直肠癌分期中的效能。
本研究共纳入50例患者(男性36例,女性14例)。手术分期数据用作比较EUS、MRI和MDCT在直肠癌术前T分期和N分期中的检出率的参考标准。比较采用卡方检验。
患者的平均年龄±标准差为60±12岁(范围:28 - 80岁)。手术病理中直肠肿瘤根据T分期和N分期的分布如下:T1(n = 2)、T2(n = 15)、T3(n = 22)、T4(n = 11);N0(n = 22)、N1 - 2(n = 28)。对于T2期肿瘤,EUS的准确率在统计学上高于MDCT(92%对64%;p < 0.01)和MRI(92%对72%;p < 0.01)。对于T3期肿瘤,与MDCT(90%对58%;p < 0.01)和MRI(90%对60%;p < 0.01)相比,EUS在分期方面具有统计学上更好的准确性。至于T4期肿瘤,EUS的准确率高于MRI(98%对80%;p < 0.01)。各检查方式在检测淋巴结的准确率方面无统计学差异(EUS为84%;MDCT为76%;MRI为70%;p = 无显著差异)。
在直肠癌的T分期中,EUS似乎比MDCT和MRI更准确。在淋巴结分期方面,EUS、MDCT和MRI的表现相似。