目的:确定MRI是否可以预测卵巢癌(OC)患者直肠乙状结肠切除术(RR)的必要性,并比较新辅助化疗(NACT)MRI前后的预测准确性。
方法:对82位OC的MRI进行回顾性分析,包括六个肠征(长度,横轴,厚度,周长,肌层受累,和粘膜下水肿)和四个肠旁体征(阴道,准晶,输尿管,和骶直肠生殖器隔膜受累)。测量反映肌层受累程度的参数。根据手术和术后结局将患者分为非RR组和RR组。通过多变量逻辑回归分析确定了需要RR的独立预测因素。
结果:对82例患者进行了影像学评估(67例无NACT,15例NACT)。粘膜下水肿和肌层受累(OR分别为13.33和8.40)是需要RR的独立预测因子,敏感性为83.3%和94.4%,特异性为93.9%和81.6%,分别。在反映肌层受累程度的参数中,周长≥3/12的预测精度最高,将特异性从仅肌层受累的81.6%增加到98.0%,灵敏度仅略有下降(从94.4%降至88.9%)。NACT前和NACT后MRI的预测敏感性分别为100.0%和12.5%,分别,特异性分别为85.7%和100.0%,分别。
结论:直肠乙状肌受累及其周围的MRI分析有助于预测OC患者RR的必要性,NACT前MRI可能更适合评估。
■我们分析了OC患者的术前盆腔MRI。我们的研究结果表明,MRI对识别需要RR达到ODS的患者具有预测潜力。
结论:必须确定RR的需求,以优化OC患者的治疗。肌层受累围≥3/12有助于预测RR。在预测RR方面,NACT前MRI可能优于NACT后MRI。
OBJECTIVE: To determine whether MRI can predict the necessity of rectosigmoid resection (RR) for optimal debulking surgery (ODS) in ovarian cancer (OC) patients and to compare the predictive accuracy of pre- and post-neoadjuvant chemotherapy (NACT) MRI.
METHODS: The MRI of 82 OC were retrospectively analyzed, including six bowel signs (length, transverse axis, thickness, circumference, muscularis involvement, and submucosal edema) and four para-intestinal signs (vaginal, parametrial, ureteral, and sacro-recto-genital septum involvement). The parameters reflecting the degree of muscularis involvement were measured. Patients were divided into non-RR and RR groups based on the operation and postoperative outcomes. The independent predictors of the need for RR were identified by multivariate logistic regression analysis.
RESULTS: Imaging for 82 patients was evaluated (67 without and 15 with NACT). Submucosal edema and muscularis involvement (OR 13.33 and 8.40, respectively) were independent predictors of the need for RR, with sensitivities of 83.3% and 94.4% and specificities of 93.9% and 81.6%, respectively. Among the parameters reflecting the degree of muscularis involvement, circumference ≥ 3/12 had the highest prediction accuracy, increasing the specificity from 81.6% for muscularis involvement only to 98.0%, with only a slight decrease in sensitivity (from 94.4% to 88.9%). The predictive sensitivities of pre-NACT and post-NACT MRI were 100.0% and 12.5%, respectively, and the specificities were 85.7% and 100.0%, respectively.
CONCLUSIONS: MRI analysis of rectosigmoid muscularis involvement and its circumference can help predict the necessity of RR in OC patients, and pre-NACT MRI may be more suitable for evaluation.
UNASSIGNED: We analyzed preoperative pelvic MRI in OC patients. Our findings suggest that MRI has predictive potential for identifying patients who require RR to achieve ODS.
CONCLUSIONS: The need for RR must be determined to optimize treatment for OC patients. Muscularis involvement circumference ≥ 3/12 could help predict RR. Pre-NACT MRI may be superior to post-NACT MRI in predicting RR.