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Application Research of Magnetic Resonance Imaging in Diagnosis and Preoperative Staging of Rectal Cancer

Author: DuWenFeng
Tutor: YangDaoGui
School: Taishan Medical College
Course: Surgery
Keywords: Rectal cancer Magnetic resonance imaging Tumor stage Preoperative evaluation
CLC: R735.37
Type: Master's thesis
Year: 2011
Downloads: 18
Quote: 0
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Abstract


The research background cancer is one of the most common gastrointestinal cancer and serious threat to human health, showed an upward trend in the incidence of domestic and foreign, in recent years, China's incidence rate is much higher than abroad. Successful tumor resection mainly rely on accurate tumor staging and surgical techniques appropriate, therefore, accurate preoperative staging, and then targeted the development of personalized treatment options is very important. Plays a vital role in rectal cancer preoperative staging imaging studies, including MRI has a high resolution of soft tissue, can clearly show the rectum and its adjacent tissues and organs in the staging of rectal cancer has important value. In recent years, it has been more and more attention of clinicians. The 3.0T MR purposes 3.0T high-resolution MR pathology results as the gold standard of primary rectal cancer preoperative imaging studies, its results Relevance explore preoperative T and N staging diagnostic accuracy, accurate cut the distance between the edge of the anal margin surgery the MR curve measurement techniques to measure the tumor specimens measuring distance compared explore 3.0T MR measurement curve distance between the lower edge of the tumor and the anal margin sex. Collection 2009.9-2011.1 Liaocheng People's Hospital during the treatment of gastrointestinal surgery by surgery and pathology of primary rectal cancer were 53 patients, all patients in the preoperative MRI was performed MRI sequences including the conventional TSE-the T1WI,-T2WI diffusion imaging (DWI) on T2WI. using fast spin echo (TSE) sequence and inversion recovery the frequency saturation imaging (SPIR) sequence, some patients using enhanced scan, scan using a multi-dimensional imaging, to observe tumor size and signal around the infiltration, lymph node Increase the distance between the lower edge of the situation and analysis of the tumor and the anal verge curve. Histopathology results as the gold standard, were analyzed using SPSS13.0 statistical software, computing 3.0T MR accuracy in the evaluation of tumor T stage and N stage and T and N staging accuracy, sensitivity, specificity, , positive predictive value, negative predictive value. Using paired T-test and statistical methods to analyze the relevance of the curve distance between the lower edge of the tumor and the anal margin measurement results in a timely manner and surgical specimens cut. Results in 53 patients with rectal cancer, MRI of rectal cancer correct T staging of 44 cases, low stage four cases, excessive staging five cases, the overall accuracy rate was 83.1% (44/53), the T1 period accuracy 66.7% (2/3), T2 of 77.8% (14/18), T3 of 88.9% (24/27), T4 of 80% (4/5). Statistically pathology and MRI T stage is a good agreement (Kappa = 0.713, P = 0.000); assessment of lymph node staging accuracy of MRI of rectal cancer N 67.9%, statistics show Pathology has XX consistency (Kappa = 0.516, P = 0.000) and MRI N stage. MRI measurement of rectal tumor under the edge of the anal margin curve distance and surgical specimens measured values ??no significant statistical difference (t = 1.845, P = 0.077). Conclusion MRI for rectal cancer diagnosis and preoperative T and N staging high accuracy, and can clearly show the lesions and the surrounding structures, more accurate measurement of the tumor under the edge of the curve distance from the anal margin, so the correct guidance rectal cancer preoperative treatment program, and clinical choice of surgical approach has a good guide.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Rectal cancer
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