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目的评价磁共振成像对肾癌术前TNM分期的诊断价值。方法回顾性分析山东省淄博市中心医院2000年3月～2004年5月收治的36例经手术病理证实的肾癌患者临床和影像学资料。对36例患者术前MRI(均包括T1WI、T2WI及动态增强扫描)表现应用1997年肾癌TNM分期法进行分期。将MRI分期与术后病理分期进行对照,应用Kappa检验评定两者的一致性。结果在T分期及M分期中,MRI分期与手术病理分期有良好的一致性(K值分别为K=0.896,K=0.786)。在判定肾癌并静脉系统受累方面,MRI分期与病理分期有非常高的一致性(K=1)。但N分期两者一致性较差(K=0.367)。结论MRI可用于肾癌术前TNM分期,其对T期、M期及静脉系统受累的评价准确性高,但对N期评价准确性较差。
Objective To evaluate the diagnostic value of magnetic resonance imaging in preoperative TNM staging of renal cell carcinoma. Methods The clinical and imaging data of 36 patients with pathologically confirmed renal cell carcinoma admitted from March 2000 to May 2004 in Zibo Central Hospital of Shandong Province were retrospectively analyzed. Thirty-six patients underwent preoperative MRI (including T1WI, T2WI and dynamic contrast-enhanced scan) staging 1997 TNM staging. MRI staging and postoperative pathological staging were compared, the application of Kappa test to assess the consistency between the two. Results T stage and M stage, MRI staging and surgical pathology staging had good consistency (K values were K = 0.896, K = 0.786). In determining the involvement of renal cell carcinoma and venous system, MRI staging and pathological staging has a very high consistency (K = 1). However, the agreement between the two groups was poor (K = 0.367). Conclusion MRI can be used for the preoperative TNM staging of renal cell carcinoma, which has high accuracy in assessing T, M and venous system involvement, but its accuracy in evaluating N stage is poor.