MRI在评估直肠癌局部淋巴结转移中的应用价值

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Abstract Objective: To evaluate the application of MRI in the diagnosis of regional lymph node metastasis in rectal cancer. Methods: During the period from May to December 2015, 94 patients with pathologically-proved rectal underwent MRI were included. The clinical data were retrospectively analyzed. The short-axis diameter, margin, signal and ADC values of the target node and the signal of perirectal fat were observed and recorded. Patients were assigned to the malignant node or benign node group according to pathological analysis. Chi-square(χ2) trend test was used to test the margin, signal and the signal of perirectal fat of metastasizing lymph nodes and nonmetastasizing lymph nodes, short-axis diameter and ADC values were compared using the t-test. Multivariate analysis to determine independent significant individual variables by multiple Logistic regression analysis. ROC curve analysis was done to evaluate the diagnostic efficiency. Results: The margin, signal of lymph nodes and signal of perrectal fat showed correlation with the lymph node metastasis(P＜0.05). The short-axis diameter of metastatic nodes and non-metastatic nodes was (6.25±2.25) mm and(4.80±1.38) mm respectively, the differences between the two groups were significant(P＜0.05). The short-axis diameter, margin, signal and the signal of perirectal fat were proved to be significant independent predictors of lymph node metastasis by Logistic regression analysis. The AUC value showed that margin carried the highest credibility for the diagnosis of lymph node metastasis, and the next were the signal of perirectal fat and signal. Conclusion: It was helpful to improve the diagnosis of lymph node metastasis by considering the short-axis diameter, margin and signal of the lymph nodes and the signal of perirectal fat, especially the margin and the signal of perirectal fat.

Key words： Rectal neoplasms Neoplasm metastasis Magnetic resonance imaging

Received: 19 May 2016

PACS:
	Ｒ735.37
	Ｒ73-37
	Ｒ445.2

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	Articles by authors
	DAI Xin
	XU Qing
	YU Jing
	LI Yan
	SHI Hai-bin

Cite this article:

DAI Xin,XU Qing,YU Jing, et al. The application value of MRI in the diagnosis of regional lymph node metastasis in rectal cancer[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(2): 112-115.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I2/112

[1]Samee A, Selvasekar CR. Current trends in staging rectal cancer[J]. World J Gastroenterol, 2011, 17(7): 828-834.
[2]陈慰慰，李增军，徐忠法. 直肠癌新辅助治疗的进展[J]. 中国医药导报，2013，10（15）：40-42.
[3]Lahaye MJ, Engelen SM, Nelemans PJ, et al. Imaging for predicting the risk factors-the circumferential resection margin and nodal disease of local recurrence in rectal cancer: a Meta-analysis[J]. Semin Ultrasound CT MR, 2005, 26(4): 259-268.
[4]李亮，韩悦，白玫，等. MRI对直肠癌术前诊断的价值[J]. 实用放射学杂志，2012，28（5）：706-709.
[5]容蓉，孙晓伟，王霄英，等. MRI和CT对原发直肠癌术前N分期的诊断研究[J]. 实用放射学杂志，2011，27（10）：1495-1498.
[6]Brown G, Richards CJ, Bourne MW, et al. Morphologic predictors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison[J]. Radiology, 2003, 227(2): 371-377.
[7]刘影，张茜. 高分辨率MRI、DWI序列对直肠癌术前TN分期的价值[J]. 中国临床保健杂志，2014，17（5）：498-501.
[8]Kim JH, Beets GL, Kim MJ, et al. High-resolution MR imaging for nodal staging in rectal cancer: are there any criteria in addition to the size?[J]. Eur J Radiol, 2004, 52(1): 78-83.
[9]Al-Sukhni E, Milot L, Fruitman M, et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: a systematic review and Meta-analysis[J]. Ann Surg Oncol, 2012, 19(7): 2212-2223.
[10]张浩波，张欢，陆兴生，等. MRI在直肠癌术前分期中的作用[J]. 外科理论与实践，2010，15（6）：647-650.
[11]Ogawa S, Hida J, Ike H, et al. Selection of Lymph Node-Positive Cases Based on Perirectal and Lateral Pelvic Lymph Nodes Using Magnetic Resonance Imaging: Study of the Japanese Society for Cancer of the Colon and Rectum[J]. Ann Surg Oncol, 2016, 23(4): 1187-1194.
[12]Beets-Tan RG, Beets GL. Local staging of rectal cancer: a review of imaging[J]. J Magn Reson Imaging, 2011, 33(5): 1012-1019.
[13]Akasu T, Iinuma G, Takawa M, et al. Accuracy of high-resolution magnetic resonance imaging in preoperative staging of rectal cancer[J]. Ann Surg Oncol, 2009, 16(10): 2787-2794.
[14]Koh DM, Brown G, Husband JE. Nodal staging in rectal cancer[J]. Abdom Imaging, 2006, 31(6): 652-659.
[15]张森，康钰，杜湘珂. 扩散加权成像评估结直肠癌区域淋巴结转移预后相关因素分析[J]. 中国医学影像学杂志，2015，23（7）：513-516.
[16]亓俊霞，白人驹，张翔，等. 薄层MRI联合MR扩散加权成像对直肠癌术前局部分期的价值[J]. 临床放射学杂志，2011，30（12）：1783-1787.
[17]马二奎，梁宇霆，郑晓丹. MR扩散加权成像对结直肠癌区域淋巴结转移的诊断价值[J]. 国际医学放射学杂志，2013，36（5）：418-421.
[18]Heijnen LA, Lambregts DM, Mondal D, et al. Diffusion-weighted MR imaging in primary rectal cancer staging demonstrates but does not characterise lymph nodes[J]. Eur Radiol, 2013, 23(12): 3354-3360.