中国医学装备2025，Vol.22Issue(12)：34-38,43,6.DOI:10.3969/j.issn.1672-8270.2025.12.007
基于3.0T多模态磁共振成像的直肠癌术前精准TNM分期的验证研究
Verification and application of preoperatively precise TNM staging based on multimodal imaging of 3.0T MRI for rectal cancer
摘要
Abstract
Objective:To investigate construction and application of a preoperatively precise Tumor Nodes Metastases(TNM)staging model based on multi-modal imaging of 3.0T magnetic resonance imaging(MRI)for rectal cancer.Methods:A total of 96 patients with rectal cancer who admitted to The First People's Hospital of Chuzhou during January 2021 and May 2025 were selected.All patients underwent multi-modal imaging examination with 3.0T MRI.Using pathological results as the"gold standard"for staging to compare the diagnostic accuracy of preoperative MRI multi-modal imaging at T staging,N staging,and M staging.Decision tree model and Bayesian network model were used to analyze the influencing factors of affecting TNM staging of patients with rectal cancer.The MRI quantitative parameters of different stages were compared.Results:Using the results of pathological examination as the gold standard for 96 patients with rectal cancer,and 14 cases were T1 stage,and 21 cases were T2 stage,and 34 cases were T3 stage and 27 cases were T4 stage in T staging.In N staging,55 cases were N0 stage,and 27 cases were N1 stage,and 14 cases were N2 stage.In M staging,87 cases were M0 stage and 9 cases were M1 stage.The results of different clinical staging of MRI multi-modal imaging showed 12 cases were T1 stage,and 22 cases were T2 stage,and 33 cases of T3 stage,and 29 cases were T4 stage,which diagnostic accuracies were respectively 64.29%,76.19%,82.35%and 88.89%,and the overall accuracy was 80.21%.There was a higher consistency at the diagnostic results between multi-modal MRI and the pathological examination(Kappa=0.727,P＜0.05).The results of decision tree model showed that differentiation degree,tumor type and CA199 were influencing factors for T staging of rectal cancer,and 45 cases were No stage,and 31 cases were N1 stage,and 20 cases were N2 stage,which diagnostic accuracies were respectively 72.73%,66.67%and 85.71%,and the total accuracy was 72.92%,and there was higher consistency at diagnostic results between it and pathological examination(Kappa=0.556,P＜0.05).The results of decision tree model also showed that differentiation degree,CA199,carcinoembryonic antigen,and tumor type were influencing factors for N staging of rectal cancer.In addition,85 cases were M0 stage,and 11 cases were M1 stage,which diagnostic accuracy was 94.25%,and the overall accuracy was 91.67%,and there was a higher consistency at the diagnostic results between it and pathological examination(Kappa=0.554,P＜0.05).The results of Bayesian model showed that carcinoembryonic antigen and CA199 were influencing factors with a higher probability for M1 stage of rectal cancer.In patients with different clinical stages of rectal cancer,with the increasing of clinical staging,the minimum apparent diffusion coefficient(ADC),average ADC,and relative ADC parameters decreasing gradually(FT=23.760,90.818,25.062,FN=49.764,84.692,30.837,P＜0.05).Conclusion:3.0T MRI multi-modal imaging has a certain diagnostic value in preoperative TNM staging for rectal cancer.关键词
磁共振成像(MRI)/多模态成像/直肠癌/临床分期Key words
Magnetic resonance imaging(MRI)/Multimodal imaging/Rectal cancer/Clinical staging分类
医药卫生引用本文复制引用
史凌波,孟庆涛,罗元满,徐伟..基于3.0T多模态磁共振成像的直肠癌术前精准TNM分期的验证研究[J].中国医学装备,2025,22(12):34-38,43,6.基金项目
安徽省高等学校科学研究项目(自然科学类)(2022AH052876) Anhui Provincial University Science Research Project(Natural Science Category)(2022AH052876) （自然科学类）
