背景:结直肠癌(CRC)是临床上普遍存在的癌症类型;其早期症状可能难以检测,这通常会导致许多患者的晚期诊断。早期发现和诊断CRC对于提高治疗成功率和患者生存率至关重要。最近,成像技术被认为是必不可少的管理CRC,磁共振成像(MRI)和螺旋计算机断层扫描(SCT)在增强诊断和治疗方法中起着重要作用。
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应用价值。
方法:厦门大学附属中山医院95例患者行MRI和SCT检查,确诊为CRC。评估MRI和SCT对CRC术前分类的准确性,病理分期作为参考。受试者工作特征曲线用于评价血容量的诊断效能,血流量,时间达到顶峰,渗透表面,血液回流常数,体积传递常数,和细胞外血管外空间体积分数对CRC患者预后的影响。
结果:病理活检证实了以下CRC阶段:T1、T2、T3和T4分别为23、23、32和17。N0期39例,N1为22,N2为34,M0级为44,M1为51。以病理结果为基准,联合使用MRI和SCT对CRC患者术前TNM分期表现出优越的敏感性,特异性,与任何一种单独的模态相比,准确性差异有统计学意义(P<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,如血容量曲线下的面积所示,血流量,时间达到顶峰,和渗透性表面,血液回流常数,体积传递常数,细胞外血管间隙体积分数分别为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(P<0.05)。
结论:MRI联合SCT对CRC患者的临床诊断有效,值得临床推广。
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.
OBJECTIVE: 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 (P < 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 (P < 0.05).
CONCLUSIONS: MRI with SCT is effective in the clinical diagnosis of patients with CRC and is worthy of clinical promotion.