磁共振成像与螺旋计算机断层扫描在结直肠癌分期及治疗预后评估中的有效性
Effectiveness of magnetic resonance imaging and spiral computed tomography in the staging and treatment prognosis of colorectal cancer.
作者信息
Bai Lu-Na, Zhang Lu-Xian
机构信息
Department of Radiology, Zhongshan Hospital Xiamen University, Xiamen 361004, Fujian Province, China.
出版信息
World J Gastrointest Surg. 2024 Jul 27;16(7):2135-2144. doi: 10.4240/wjgs.v16.i7.2135.
BACKGROUND
Colorectal cancer (CRC) is a prevalent cancer type in clinical settings; its early signs can be difficult to detect, which often results in late-stage diagnoses in many patients. The early detection and diagnosis of CRC are crucial for improving treatment success and patient survival rates. Recently, imaging techniques have been hypothesized to be essential in managing CRC, with magnetic resonance imaging (MRI) and spiral computed tomography (SCT) playing a significant role in enhancing diagnostic and treatment approaches.
AIM
To explore the effectiveness of MRI and SCT in the preoperative staging of CRC and the prognosis of laparoscopic treatment.
METHODS
Ninety-five individuals admitted to Zhongshan Hospital Xiamen University underwent MRI and SCT and were diagnosed with CRC. The precision of MRI and SCT for the presurgical classification of CRC was assessed, and pathological staging was used as a reference. Receiver operating characteristic curves were used to evaluate the diagnostic efficacy of blood volume, blood flow, time to peak, permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction on the prognosis of patients with CRC.
RESULTS
Pathological biopsies confirmed the following CRC stages: 23, 23, 32, and 17 at T1, T2, T3, and T4, respectively. There were 39 cases at the N0 stage, 22 at N1, 34 at N2, 44 at M0 stage, and 51 at M1. Using pathological findings as the benchmark, the combined use of MRI and SCT for preoperative TNM staging in patients with CRC demonstrated superior sensitivity, specificity, and accuracy compared with either modality alone, with a statistically significant difference in accuracy ( < 0.05). Receiver operating characteristic curve analysis revealed the predictive values for laparoscopic treatment prognosis, as indicated by the areas under the curve for blood volume, blood flow, time to peak, and permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction were 0.750, 0.683, 0.772, 0.761, 0.709, 0.719, and 0.910, respectively. The corresponding sensitivity and specificity values were also obtained ( < 0.05).
CONCLUSION
MRI with SCT is effective in the clinical diagnosis of patients with CRC and is worthy of clinical promotion.
背景
结直肠癌（CRC）是临床中一种常见的癌症类型；其早期症状难以察觉，这常常导致许多患者在晚期才被诊断出来。结直肠癌的早期检测和诊断对于提高治疗成功率和患者生存率至关重要。最近，有假设认为成像技术在结直肠癌的管理中至关重要，磁共振成像（MRI）和螺旋计算机断层扫描（SCT）在改进诊断和治疗方法方面发挥着重要作用。
目的
探讨MRI和SCT在结直肠癌术前分期及腹腔镜治疗预后中的有效性。
方法
厦门大学附属中山医院收治的95例患者接受了MRI和SCT检查，并被诊断为结直肠癌。评估了MRI和SCT对结直肠癌术前分类的准确性，并以病理分期作为参考。采用受试者工作特征曲线评估血容量、血流、达峰时间、通透表面积、血液回流常数、容积转移常数和细胞外血管外间隙容积分数对结直肠癌患者预后的诊断效能。
结果
病理活检确诊的结直肠癌分期如下：T1期23例，T2期23例，T3期32例，T4期17例。N0期39例，N1期22例，N2期34例，M0期44例，M1期51例。以病理结果为基准，与单独使用任何一种检查方式相比，联合使用MRI和SCT对结直肠癌患者进行术前TNM分期显示出更高的敏感性、特异性和准确性，准确性差异具有统计学意义（<0.05）。受试者工作特征曲线分析揭示了腹腔镜治疗预后的预测价值，血容量、血流、达峰时间、通透表面积、血液回流常数、容积转移常数和细胞外血管外间隙容积分数的曲线下面积分别为0.750、0.683、0.772、0.761、0.709、0.719和0.910。还获得了相应的敏感性和特异性值（<0.05）。
结论
MRI联合SCT对结直肠癌患者的临床诊断有效，值得临床推广。
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