摘要
目的 对比多层螺旋CT(MSCT)与磁共振成像(MRI)在评估食管癌T分期的临床价值。方法 收集2018年11月至2021年12月我院收治的食管癌患者128例的临床资料。观察肿瘤形态、密度、强化形式等特征。以病理结果为金标准,评估MSCT、MRI检查对食管癌术前T分期的诊断准确率。结果 经MRI检查T1~T4期的准确率分别为93.33%、88.46%、94.74%、93.33%,对食管癌术前T分期诊断准确率为92.97%(119/128),与病理结果一致性(Kappa=0.930,P<0.001)。经MSCT检查T1~T4期的准确率分别为26.67%、73.08%、82.46%、66.67%,对食管癌术前T分期诊断准确率为70.31%(90/128),与病理结果一致性(Kappa=0.703,P<0.001)。MSCT诊断食管癌T分期准确率明显低于MRI(P<0.05)。食管癌病灶经MRI扫描可见T1等信号或T2稍高信号,DWI呈高信号;食管三层结构在T2WI及其抑脂序列上呈黏膜层等信号、下层高信号及肌层低信号;增强扫描呈中度强化,强化多不均匀。结论 MSCT、MRI均可有效显示食管癌影像学特征,在食管癌术前分期中具有一定价值,但MRI对T分期的诊断准确率更高,更有利于术前获取肿瘤病灶累及区域的可靠信息。
Objective To compare the clinical value of multi-slice spiral CT(MSCT) with magnetic resonance imaging(MRI) in the evaluation of T staging of esophageal cancer.Methods Clinical data of 128 patients with esophageal cancer in our hospital from November 2018 to December 2021 were collected. Tumor morphology, density and enhancement were observed. Using pathological results as the gold standard, the diagnostic accuracy of MSCT and MRI for preoperative T-staging of esophageal cancer was evaluated.Results The accuracy rates of T1~T4 stages detected by MRI were 93.33%, 88.46%, 94.74%, and 93.33%, respectively. The diagnostic accuracy of preoperative T staging of esophageal cancer was 92.97%(119/128), which was consistent with the pathological results(Kappa = 0.930, P<0.001). The accuracy rates of T1~T4 stages detected by MSCT were 26.67%, 73.08%, 82.46% and 66.67%,respectively. The diagnostic accuracy of preoperative T staging of esophageal cancer was 70.31%(90/128), which was consistent with pathological results(Kappa = 0.703, P<0.001). The accuracy rate of MSCT in diagnosing T staging of esophageal cancer is significantly lower than that of MRI(P<0.05). Esophageal cancer lesions could be seen with T1 isointense or slightly high T2 signal on MRI scan, and DWI was high signal. The three-layer structure of the esophagus showed isointensity in the mucosal layer, hyperintensity in the lower layer and hypointensity in the muscular layer on T2 WI and its fat suppressing sequence. Enhanced scan showed moderate enhancement, and the enhancement was uneven.Conclusions Both MSCT and MRI can effectively display the imaging features of esophageal cancer. They have a certain value in preoperative staging of esophageal cancer. However, MRI has a higher diagnostic accuracy for T staging and is more conducive to obtaining reliable information about the area of tumor lesions before surgery.
作者
郝俊飞
黎娅
吴绍全
夏太玉
HAO Jun-fei;LI Ya;WU Shao-quan;XIA Tai-yu(Dazu People′s Hospital,Chongqing 402360,China)
出处
《实用医院临床杂志》
2022年第6期116-118,共3页
Practical Journal of Clinical Medicine
关键词
磁共振成像
多层螺旋CT
食管癌
T分期
Magnetic resonance imaging
Multi-slice spiral CT
Esophageal cancer
T staging
