Research On Prediction Of MRI In Circumferential Resection Margin And Extramural Vascular Invasion Of Rectal Cancer

Objectives To investigate the clinical value of MRI detect circumferential resection margin and extramural vascular invasion for the patients with rectal cancer,so as to provide the basis for selecting treatment options and evaluation of the prognosis for patients with rectal cancer.Methods From December 2014 to October 2016,we choose 58 patients with histologically proved rectal cancer by the colonoscopy and biopsies in Tangshan Worker Hospital.Including 32 males and 26 females.Aged 38-75 years,and the average age of the patients is 62 years.Which 9 cases tumor were located in upper rectal,29 in middle rectal,20 in distal rectal.All the patients underwent pelvic plain and enhanced MRI before surgery,which underwent total mesorectum excision operation within 1 week after MRI examination.Pathology detect circumferential resection margin and extramural vascular invasion.Using pathology as the “gold standard”,Concordance between radiologic staging of circumferential resection margin,extramural vascular invasion and pathologic reporting was assessed by means of the Kappa statistic.Results 1 For circumferential resection margin,of 47 cases of middle and distal rectal cancer patients,histopathological examination shows that 15 cases circumferential resection margin involvement,and 32 cases without circumferential resection margin involvement.MRI accurately identify the 41 cases.In the 15 cases of CRM positive patients,MRI accurately identify 13 cases.For the 32 cases CRM negative patients,MRI accurately identify 28 cases.Statistically,there was a high correlation between pathologic and MRI detected circumferential resection margin(Kappa=0.716,P=0.000).2 For extramural vascular invasion,for all of the 58 patients,the pathology shows that 11 cases patients with extramural vascular invasion,47 cases patients without extramural vascular invasion.MRI accurately identify 51 cases patients.For the 11 cases EMVI positive patients,MRI accurately identify 9cases;for the 47 cases EMVI negative patients,MRI accurately identify 42 cases.Statistically,there was a common correlation between pathologic and MRI detected extramural vascular invasion(Kappa=0.644,P=0.000).Conclusions 1 MRI can provide a good assessment of the circumferential resection margin in patients with rectal cancer.2 MRI can provide a high accuracy of assessing whethere extramural vascular invasion in patients with rectal cancer.3 MRI detect circumferential resection margin and extramural vascular invasion for the patients with rectal cancer before surgery,it is helpful for providing the basis of selecting treatment options and evaluation of the prognosis for patients with rectal cancer.