The Value Of 3.0T Magnetic Resonance In Preoperative Evaluation Of Staging Rectal Cancer

Objective: By using the 3.0T MRI imaging before operation of rectal cancer,we can evaluate the stage of rectal cancer to provide a reliable imaging basis for clinical diagnosis and personalized treatment.Methods: adopted retrospective analysis.All the 66 patients were selected from those who hospitalized in the general surgery department of Nanhua University Affiliated Chenzhou NO.1 People's Hospital from february 2016 to march 2017 and were diagnosed to be rectal cancer with colonoscopy and pathological biopsy.All patients underwent high-resol ution sagittal T2 WI,axial T2 WI,coronal T2 WI,conventional axial T1WI of the pelvis using a GE Signa HDXT 3.0T superconducting magnetic resonance scanner,High b value(b = 1000 s / mm2)Axial DWI and Axial IDEAL Enhanced scan.All the MRI images were analyzed by two deputy chief physicians,who evaluated preoperative T and N stages of rectal cancer,predicted whether or not the circumference was involved(CRM),and measured the distances from the lower edge of the tumor to the analmargin.The kappa test and T test were used to analyze the diagnostic results and surgical specimens and pathological results of the estimated images.Results: 66 cases of rectal cancer included: 18 in upper rectal cancer,21 in middle rectal cancer,27 in lower rectal cancer.The accuracy rate of MRI T staging diagnosis was 87.9%,In the 58 cases,only 6 cases were higher staged and 2 cases lower staged.One case of stage T1 was mistaken for stage T2;3 cases of T2 were mistaken for stage T3;one case of stage T3 was mistaken for stage T2,2 cases of s tage T3 were mistaken for stage T4;one case of stage T4 was mistake n for stage T3.In the MRI N staging,47 cases were correctly staged,2 cases of stage N1 were mistaken for stage N0,6 cases of N0 were mistaken for stage N1,7 cases of N2 were mistaken for stage N1,4 cases of stage N1 were mistaken for stage N2.Statistics showed that preoperative MRI T staging of rectal cancer and postoperative pathological T staging had a good consistency,the kappa value was 0.824.MRI N staging had moderate consistency,the kappa value was 0.544.the accuracy ofMRI in assessing whether the involvement of the mechanical margin is 93.9%.In the preoperative MRI measurement of the lower edge of the rectal cancer to the distance between the anal and the distance measured after surgery,the difference was not statistically significant(P>0.05).Conclusion: 3.0T MRI can effectively determine the extent of rectal cancer infiltration and accurately make T staging and the general accuracy of the N stage.The surgical circumferential margin was associated with accurate assessment,preoperative accurate measurement of the lower edge of the tumor and anal margin distance.It was of an important guiding value in providing individualized treatment programs and an empirical imaging basis before operation.