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目的:分析直肠癌直肠系膜内淋巴结的MRI表现,评价MRI在直肠癌术前N分期中的应用价值。方法:对2011年8月至2012年2月经手术治疗并经病理证实的116例直肠癌病例行术前MRI检查,观察和记录每个淋巴结的大小、边缘以及信号,以病理学诊断转移淋巴结阳性为标准进行分组,由2位影像科医生采用双盲法阅片并达成一致。结果:MRI诊断直肠周围淋巴结转移的各项诊断标准具有统计学意义,其中淋巴结短轴直径与转移相关性的统计结果为(P<0.05,r=0.210),淋巴结边缘与转移相关性的统计结果为(P<0.05,r=0.180),淋巴结信号与转移相关性的统计结果为(P<0.05,r=0.209)。Logistic回归分析显示淋巴结大小诊断淋巴结转移的可信度最高,Wals值为13.180。结论:综合分析直肠周围淋巴结大小,边缘、信号对诊断淋巴结转移有较大作用,其中以淋巴结大小的作用最为显著。
Objective: To analyze the MRI findings of rectal mesorectal lymph nodes and evaluate the value of MRI in the preoperative N staging of rectal cancer. Methods: 116 cases of rectal cancer confirmed by pathology from August 2011 to February 2012 were examined with preoperative MRI. The size, margins and signals of each lymph node were observed and recorded. The pathological diagnosis of metastatic lymph node positive The criteria were grouped and double-blind reading was performed by two imaging doctors and agreed. Results: The diagnostic criteria of MRI in the diagnosis of rectal lymph node metastasis were statistically significant (P <0.05, r = 0.210). The correlation between lymph node margin and metastasis was statistically significant (P <0.05, r = 0.180). The correlation between lymph node signal and metastasis was statistically significant (P <0.05, r = 0.209). Logistic regression analysis showed that lymph node size was the most reliable in diagnosing lymph node metastasis, with a Wals value of 13.180. Conclusion: Comprehensive analysis of the size, margins and signals of lymph nodes around the rectum has a great effect on the diagnosis of lymph node metastasis. The lymph node size is the most significant.