Objective To evaluate the diagnostic efficacy of pre-operative MR T2WI and contrast enhanced CT T staging of primary rectal cancer.Methods Fifty-one patients with primary rectal cancer were selected prospectively.Totally 27 patients underwent conventional MR and 43 patients underwent CT scan.Nineteen patients underwent both MR and CT scan.T2WI and contrast enhanced CT were used to determine T staging, respectively.Radical resection of rectal carcinoma was performed in all patients.Post-operative histopathological results were taken as reference.Results The concordance of T2WI preoperative T staging with postoperative pathology was better than that of contrast enhanced CT (Kappa value: 0.72 vs 0.52, P＜0.05).MR T2WI was superior to contrast enhanced CT in the differentiation between T1/T2 tumor and T3/T4 tumor (accuracy: 88.89％ vs 79.07％; specificity: 94.74％ vs 81.25％; positive predictive value:85.71％ vs 57.14％).ROC showed that the diagnostic efficacy of MR T2WI preoperative T staging was superior to that of contrast enhanced CT.Conclusion MR T2WI is more accurate than contrast enhanced CT in local T staging of rectal cancer, especially in assessment of T1/T2 and T3/T4 tumors.%目的 比较MR T2WI和增强CT对原发直肠癌术前T分期的诊断效能.方法 51例经活检病理证实的原发直肠腺癌,术前其中27例接受常规MR检查,43例接受CT检查,19例接受MR和CT检查.用MR T2WI和增强CT图像对肿瘤浸润深度进行判断,并与术后病理结果对照.结果 MR T2WI对直肠癌术前T分期与术后病理的一致性优于增强CT(Kappa值0.72 vs 0.52,P<0.05),对原发直肠癌T1/T2和T3/T4分期准确率高于增强CT(88.89% vs 79.07%);MR T2WI鉴别T1/T2、T3/T4期肿瘤的特异度(94.74% vs 81.25%)、阳性预测值(85.71% vs 57.14%)均优于增强CT.MR T2WI对T1/T2和T3/T4期肿瘤的分期效能优于CT.结论 MR T2WI在原发直肠癌术前T分期评价中的效能优于增强CT.
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