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目的探讨高分辨率磁共振成像(MRI)对肛管上缘定位的判断价值。方法根据75例中低位直肠癌患者的MRI影像资料,判断肛管上缘的位置,测量直肠病灶下缘与肛管上缘的距离,并进行术前术式预测(>2cm可行保肛术治疗),预测结果与术后情况作比较。结果 MRI预测可保肛46例,非保肛29例;手术行保肛术43例,非保肛术32例。MRI预测和实际手术均为行保肛术40例,均为行非保肛术26例,准确率88.00%(66/75)。MRI术前预测与术后情况一致性好(Kappa=0.754)。结论高分辨率MRI检查方便,对肛管上缘判断较为准确,测量病灶与肛缘距离方便,可将其作为中低位直肠癌术前常规检查。
Objective To investigate the value of high resolution magnetic resonance imaging (MRI) in determining the location of the superior margin of the anal canal. Methods Based on the MRI data of 75 patients with low and middle rectal cancer, the location of the upper edge of the anal canal was determined. The distance between the lower edge of the rectum lesion and the upper edge of the anal canal was measured. Preoperative surgical prediction (> 2cm) ), The predicted results compared with postoperative conditions. Results The predictive value of MRI was 46 cases of anus and 29 cases of non-anus, and 43 cases of anus-preserving surgery and 32 cases of non-anus-preserving surgery. Forty cases of anal sphincter preservation were predicted by MRI and the actual operation were performed. All of them were performed non-sino-anal suturing in 26 cases, the accuracy rate was 88.00% (66/75). MRI preoperative prediction and postoperative consistency (Kappa = 0.754). Conclusion High-resolution MRI examination is convenient, and it is more accurate to judge the upper edge of the anal canal. It is convenient to measure the distance between the lesion and the anal verge. It can be used as routine preoperative examination of low and middle rectal cancer.