The value of transrectal ultrasonography and MRI in preoperative diagnosis of peripherally incised margin of middle and low rectal cancer
10.3760/cma.j.cn431274-20231125-00601
- VernacularTitle:经直肠超声和MRI检查对中低位直肠癌术前环周切缘的诊断价值
- Author:
Yue WEN
1
;
Guozhu WU
;
Yue GAO
Author Information
1. 内蒙古自治区人民医院超声医学科，呼和浩特 010017
- Keywords:
Rectal neoplasms;
Margins of excision;
Endorectal ultrasonography;
Magnetic resonance imaging
- From:
Journal of Chinese Physician
2024;26(11):1627-1631
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of transrectal ultrasound (ERUS) and magnetic resonance imaging (MRI) in the preoperative diagnosis of peripheral margin (CRM) for middle and low rectal cancer.Methods:The clinical data of 89 patients with rectal cancer treated in the Inner Mongolia Autonomous Region People′s Hospital from January 2015 to January 2023 were retrospectively analyzed. The relationship between clinicopathological factors and CRM involvement in middle and low rectal cancer was analyzed. Using postoperative pathology as the gold standard, the accuracy and diagnostic efficacy of CRM in preoperative assessment of low and middle rectal cancer by ERUS and MRI were analyzed.Results:All the 89 patients had postoperative pathological results of rectal cancer, of which 77 were CRM-negative and 12 were CRM-positive, the positive rate was 13.48%(12/89). Pathological TN stage and extramural vascular invasion (EMVI) of rectal cancer were associated with CRM involvement in middle and low rectal cancer, with statistical significance (all P<0.05). Compared with the pathological results, the accuracy of ERUS preoperative assessment of CRM involvement was 88.76% (Kappa=0.578, P<0.001), the sensitivity was 75.00%, the specificity was 90.91%, the negative predictive value was 95.89%, the positive predictive value was 56.25%, and area under the curve (AUC) was 0.788. The accuracy rate of CRM involvement before MRI was 88.76% (Kappa=0.602, P<0.001), sensitivity was 83.33%, specificity was 89.61%, negative predictive value was 97.18%, positive predictive value was 55.56%, and AUC was 0.830. There was no significant difference in AUC between the two groups ( Z=0.420, P=0.674). Conclusions:ERUS and MRI have high accuracy in preoperative assessment of CRM status in patients with middle and low rectal cancer. ERUS can be used as a supplement to MRI for preoperative assessment of CRM in patients with middle and low rectal cancer.
