The Reference Value Of MRI In The Selection Of Surgical Methods For Rectal Cancer

Objectives Talk about the accuracy of the position relationship between the rectum cancer and The relationship between the levator ani muscle and the anorectal ring.At the same time,this study evaluated the accuracy of MRI in predicting the operation mode according to the actual operation mode,and provided the basis for the choice of preoperative operation mode for MRI.Methods The reaearch choosed the period from September in 2015 to September in 2017.60 Rectal cancer patients who treat in Tangshan Workers Hospital.Collecting some documents off the patients.Using the position of musculi levator ani and anorectal ring.The vertical line between the origin of levator ani and the median line of the body or the horizontal plane of the extension line were taken as the first boundary plane and the second boundary plane as the anorectal circle plane.We divide the rectum into three parts,the first part is on the first boundary plane.The second part is under the boundry plane.The third part is under the second boundry plane.Using location of rectal cancer,levator ani muscle and anorectal ring in MRI coronal and sagittal images.Using the location of the lower margin of the cancer as the entry criterion,MRI predicts that the rectal cancer is located in each segment.When the lower margin of the cancer is in the same plane as the boundary plane,the rectal cancer is classified in the next paragraph.We should use the pathological judgement after the operation to predict whether the position is correct,then collecting the number of rectal cancer.Comparing the number of segments predicted by MRI with the actual ones.The accuracy of MRI in the location of each tumor segment was statistically obtained,and the influence of various factors on the prediction of tumor location by MRI was analyzed according to sex,tumor grade,tumor staging and tumor size stratification.According to MRI prediction,60 patients with rectal cancer were divided into groups.Each rectal cancer patient was selected according to the MRI predictive surgical evaluation criteria and the number of different surgical procedures for each segment was collected,and the number of different surgical procedures used in each segment of the operation was collected.SPSS 22.0 statistical software was used to analyze the data.Results In this study,60 patients with rectal cancer were located in the first segment(23 cases),the second stage(21 cases)and the third stage(16 cases)according to MRI prediction.After operation and pathological judgment,the actual number of cases was 23 in the first segment,19 in the second segment and 18 in the third segment.Compared with the actual rectal cancer tumor location,the accuracy of MRI in recognizing rectal cancer from the first segment to the third segment was 95.65%,89.47%,and 83.33%,respectively,and the total accuracy rate was 90%.The position and actuality of rectal cancer were further analyzed.The consistency of the location showed Kappa = 0.849(P < 0.001),which was statistically significant.According to sex,tumor grading and tumor size stratification,the influence of various factors on the location of MRI was analyzed.The results were not statistically significant.The patients’ surgical methods were divided into two groups: the first group included the anus-preserving group including low anterior resection(Dixon surgery),sphincterectomy(ISR operation),and partial resection;the second group was non-anus group including Miles,only.There were 22 cases in the anus preserving group and 1 cases in the non-anus group in the first segment of MRI,13 cases in the anus preserving group and 8 cases in the non-anal preserving group in the second stage,and 8 cases in the third segment in the MRI predictive operation group.There were 8 cases in the group without anus preservation.There were 21 cases in the first stage of operation,2 cases in the non-anus group,9 cases in the anus preserving group and 12 cases in the unpreserved anus group in the second stage,and 8 cases in the actual anal preservation group and 11 cases in the non-anal preservation group in the third segment.According to the actual rectal cancer operation method,the accuracy of MRI in predicting rectal cancer surgery is 85.00%,with the highest accuracy of 95.60% in the first segment,80.95% in the second segment,and 81.25% in the third segment;further analysis The consistency of MRI in predicting rectal cancer surgery and actual rectal cancer surgery showed that Kappa=0.713(P<0.001),which was statistically significant.Among them,the first segment of MRI predicts the consistency between rectal cancer surgery and actual rectal cancer surgery,Kappa=0.646(P<0.001);the second segment of MRI predicts the consistency of rectal cancer surgery and actual rectal cancer surgery.Kappa=0.632(P<0.001);The third segment of MRI predicts the consistency between rectal cancer surgery and actual rectal cancer surgery,Kappa=0.625(P<0.001).Conclusions 1.MRI can accurately assess the positional relationship between rectal cancer and the levator ani muscle or anorectal rectum,and it can quickly provide clinical first-line workers with positioning assistance for rectal cancer.2.MRI predicts the accuracy of rectal cancer surgery,providing a reliable reference for preoperative selection and helping clinicians determine which surgical approach is suitable for a particular patient.