早期直肠癌的MRI;比萨科迪尔微阴道增加了粘膜下面的宽度,读者信心和瘤显著性
Ellen Viktil1,2, Bettina Andrea Hanekamp3,4, Arild Nesbakken4,5
1Department of Radiology, Oslo University Hospital Ullevål, Oslo, Norway. uxelkt@ous-hf.no.
Abdominal radiology (New York)
|December 8, 2024
概括
微阴道显著改善了下膜的宽度,读者信心和瘤明显性,用于MRI早期直肠癌 (ERC) 的分期. 虽然诊断准确度没有变化,但T分期的信心和准确度有所改善.
科学领域:
- 胃肠道放射学 胃肠道放射学
- 瘤成像学成像学
- 结直肠癌的分期是什么
背景情况:
- 早期直肠癌 (ERC) 的准确分期对于治疗规划至关重要.
- 磁共振成像 (MRI) 是ERC分期的一个关键模式.
- 增强肌下侵袭的MRI可视化是积极研究的一个领域.
研究的目的:
- 为了评估微阴对基于MRI的ERC阶段的影响.
- 评估诊断性能的变化,下粘膜宽度,读者信心和瘤显著性的变化.
- 为了确定微浸泡剂的管理是否改善ERC阶段化中的读者间协议.
主要方法:
- 一项单中心研究包括50名参与者怀疑ERC.
- 所有参与者都接受了带有或没有微阴道 (MRin和MRex) 的MRI.
- 两位经验丰富的放射科医生评估了诊断性能,粘膜下宽度,T分期信心和瘤显著性,其中基因病理学是黄金标准.
主要成果:
- 微阴道显著增加了下膜宽度 (p < 0.001),平均为2.2-2.8毫米.
- 读者对T阶段和瘤明显性的信心显著改善 (p < 0.005).
- 正确分期并具有高读者信心的瘤比例从42-58%增加到72-80% (p=0.002-0.04).
- 读者之间的一致性从中度 (kappa 0.58) 提高到良好 (kappa 0.68).
结论:
- 微阴道显著增强了下粘膜的宽度,读者信心,并在MRI的瘤显著ERC.
- 虽然T阶段的整体灵敏度和特异性没有改善,但正确的T阶段和高读者信心的组合显著增强.
- 微浸泡剂的使用改善了在早期直肠癌的MRI分期中读者间的协议.
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