Preoperative staging of rectal cancer: Comparison of 3-T high-field MRI and endorectal sonography
Preoperative staging of rectal cancer: Comparison of 3-T high-field MRI and endorectal sonography
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DOI：
10.2214/ajr.05.1234
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发表时间：
2006-12-01
影响因子：
5
通讯作者：
Kim, Chan Kyo
中科院分区：
文献类型：
--
作者：
Chun, Ho-Kyung;Choi, Dongil;Kim, Chan Kyo
OBJECTIVE.本研究的目的是比较相控阵3-T MRI和直肠内超声在直肠癌术前分期中的作用。在8个月的时间里，24例直肠癌患者在手术切除前3周接受了相控阵线圈和7.5至10 MHz直肠内超声检查的3-T MRI。三名放射科医生独立审查了MR和直肠内超声图像。切除标本的组织病理学结果被用来评估这些技术的固有肌层和直肠周围组织的浸润和淋巴结受累的敏感性和特异性。采用受试者工作特征（ROC）分析比较两种技术的诊断准确性。对于固有肌层侵犯，MRI和直肠超声检查的平均敏感性均为100%，平均特异性分别为66.7%和61.1%。平均灵敏度和特异性的差异无统计学意义（每种情况下p > 0.05）。对于直肠周围组织侵犯，MRI和直肠内超声检查的敏感性和特异性相当（91.1% vs 100%，92.6% vs 81.5%; p > 0.05）。淋巴结转移的敏感性和特异性也相似（63.6%vs57.6%，92.3%vs82.1%，p > 0.05）。固有肌层浸润和淋巴结受累的ROC曲线显示诊断准确性无差异。直肠腔内超声诊断直肠周围组织侵犯的ROC曲线下面积（A（z）= 0.996）高于MRI（A（z）= 0.938，p = 0.028）。对于固有肌层浸润和淋巴结受累，3-T MRI的敏感性、特异性和准确性与直肠内超声相似，但对于直肠周围组织浸润，3-T MRI的准确性低于直肠内超声。
OBJECTIVE. The aim of this study was to compare phased-array 3-T MRI and endorectal sonography in the preoperative staging of rectal cancer.MATERIALS AND METHODS. During an 8-month period, 24 patients with rectal cancer underwent both 3-T MRI performed with phased-array coils and 7.5- to 10-MHz endorectal sonography in the 3 weeks before surgical resection. Three radiologists independently reviewed the MR and endorectal sonographic images. The histopathologic findings in resected specimens were used to evaluate the sensitivities and specificities of these techniques for invasion of the muscularis propria and perirectal tissue and for lymph node involvement. Receiver operating characteristic (ROC) analysis was used to compare the diagnostic accuracies of the techniques.RESULTS. For muscularis propria invasion, the mean sensitivities of both MRI and endorectal sonography were 100%, and the mean specificities were 66.7% and 61.1%, respectively. The differences in the mean sensitivities and specificities were not statistically significant (p > 0.05 in each case). For perirectal tissue invasion, MRI and endorectal sonography had comparable sensitivities and specificities (91.1% vs 100%, 92.6% vs 81.5%; p > 0.05 in each case). They also had similar sensitivities and specificities for lymph node involvement (63.6% vs 57.6%, 92.3% vs 82.1%; p > 0.05 in each case). ROC curves for muscularis propria invasion and lymph node involvement showed no differences in diagnostic accuracy. The mean area under the ROC curve for endorectal sonography (A(z) = 0.996) for perirectal tissue invasion, however, showed higher accuracy than that of MRI (A(z) = 0.938, p = 0.028).CONCLUSION. The sensitivity, specificity, and accuracy of 3-T MRI were similar to those of endorectal sonography for muscularis propria invasion and lymph node involvement, but for perirectal tissue invasion, 3-T MRI was less accurate than endorectal sonography.