CAJ | 학술논문

目的：探讨直肠腔内水囊在直肠癌MRI术前分期中的应用价值。方法36例经肠镜病理证实直肠癌患者，术前MRI检查前置入直肠腔内水囊，比较术前MRI临床分期(肿瘤T分期、淋巴结转移N分期及环周切缘受累)和术后病理结果，判断直肠腔内水囊置入后MRI检查在直肠癌术前分期中应用价值。结果直肠腔内水囊置入后MRI检查对直肠癌T分期及环周切缘受累判断与病理学分期诊断一致性好(Kappa值分别为0.751,0.769；P<0.01)，对肿瘤T分期的总准确率为95%，环周切缘受累判断准确率为91.7%，而淋巴结转移N分期与病理学分期一致性具有一般统计学意义(Kappa值=0.613；P<0.01)，淋巴结转移N分期总准确率为80.6%。结论直肠腔内水囊置入后MRI检查对肿瘤T分期的诊断具有较大价值，并能准确预测环周切缘受累情况，而对淋巴结转移N分期只能作一般性预测。
목적：탐토직장강내수낭재직장암MRI술전분기중적응용개치。방법36례경장경병리증실직장암환자，술전MRI검사전치입직장강내수낭，비교술전MRI림상분기(종류T분기、림파결전이N분기급배주절연수루)화술후병리결과，판단직장강내수낭치입후MRI검사재직장암술전분기중응용개치。결과직장강내수낭치입후MRI검사대직장암T분기급배주절연수루판단여병이학분기진단일치성호(Kappa치분별위0.751,0.769；P<0.01)，대종류T분기적총준학솔위95%，배주절연수루판단준학솔위91.7%，이림파결전이N분기여병이학분기일치성구유일반통계학의의(Kappa치=0.613；P<0.01)，림파결전이N분기총준학솔위80.6%。결론직장강내수낭치입후MRI검사대종류T분기적진단구유교대개치，병능준학예측배주절연수루정황，이대림파결전이N분기지능작일반성예측。
Objective To investigate the value of the magnetic resonance imaging (MRI) with intrarectal water-bag in the preoperative staging of rectal cancer.Methods 36 rectal cancer patients proven by colonoscopy and pathology were inserted intrarectal water-bags into before MRI examination, by the comparison of preoperative MRI clinical stage (tumor T staging, lymph node metastasis N stage and circumferential resection margin involvement) and postoperative pathological results, the application value of MRI examination with intrarectal water-bag in resection of rectal cancer staging can be decided. Results There was an accurate correlation between pathologic and MRI examination with intrarectal water-bag in rectal cancer T stage and circumferential resection margin involvement (kappa value was 0.751, 0.769; P<0.01). The total accuracy rate of tumor T stage was 95%, the circumferential resection margin involvement in assessing the accuracy rate was 91.7%. The correlation between pathologic and MRI in node staging was generic (kappa=0.613; P<0.01), and the lymph node metastasis N staging accuracy rate was 80.6%. Conclusion MRI examination with intrarectal water-bag in tumor T staging diagnosis had great value, and it can accurately predict the circumferential resection margin involvement, and the lymph node metastasis and N staging can only make a general prediction.