使用Node-RADS对直肠癌症淋巴结进行MRI和CT的头对头比较：观察者一致性和诊断性能
A head-to-head comparison of MRI and CT using Node-RADS for rectal cancer lymph nodes: Observer agreement and diagnostic performance.
摘要(中文译文)
比较CT与MRI采用淋巴结报告与数据系统（Node-RADS）评估直肠癌术前区域淋巴结转移（LNM）的评估一致性及诊断效能。本回顾性研究纳入97例术前行增强CT和MRI检查的直肠腺癌患者，共评估148枚淋巴结（LNs）。以术后组织病理学作为参考标准。评估基于CT和基于MRI的Node-RADS评分以及ESGAR分类。通过受试者工作特征（ROC）曲线分析评估诊断效能，包括曲线下面积（AUC）、灵敏度和特异度。采用加权kappa统计评估Node-RADS的观察者间和观察者内一致性。进一步对27枚影像-病理匹配的淋巴结进行亚组分析。Node-RADS评分与病理N分期呈强正相关（MRI：r = 0.724；CT：r = 0.654；均P < 0.01）。基于MRI的Node-RADS取得最高诊断效能，显著高于基于CT的Node-RADS和ESGAR标准。两种模态的Node-RADS观察者间一致性均为良好至优秀，且MRI高于CT。对于小淋巴结（短轴直径<5 mm），基于MRI的Node-RADS的AUC高于基于CT的Node-RADS（0.895 vs. 0.760）。在影像-病理匹配亚组中，基于MRI的Node-RADS同样优于基于CT的Node-RADS。Node-RADS为直肠癌术前区域淋巴结评估提供了标准化工具，其诊断效能优于ESGAR标准。MRI的诊断效能和观察者间一致性均高于CT，支持MRI作为首选模态。
Abstract
To compare the assessment agreement and diagnostic performance of CT and MRI using the Node Reporting and Data System (Node-RADS) for preoperative regional lymph node metastasis (LNM) in rectal cancer. This retrospective study included 97 rectal adenocarcinoma patients who underwent preoperative contrast-enhanced CT and MRI. A total of 148 lymph nodes (LNs) were evaluated. Postoperative histopathology served as the reference standard. CT-based and MRI-based Node-RADS scores, as well as the ESGAR category, were assessed. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analysis, including area under the curve (AUC), sensitivity, and specificity. Inter- and intra-observer agreement for Node-RADS was evaluated using weighted kappa statistics. A subgroup analysis was further conducted on 27 image-pathology matched LNs. Node-RADS scores showed a strong positive correlation with pathological N stage (MRI: = 0.724; CT: = 0.654; both < 0.01). MRI-based Node-RADS achieved the highest diagnostic performance , which was significantly higher than CT-based Node-RADS and the ESGAR . Inter-reader agreement for Node-RADS was good to excellent for both modalities, and was higher for MRI ( ) than CT ( ). For small LNs (<5 mm in short axis diameter), MRI-based Node-RADS demonstrated a higher AUC than CT-based Node-RADS (0.895 vs. 0.760). In the imaging-pathology matched subgroup, MRI-based Node-RADS also outperformed CT-based Node-RADS . Node-RADS provides a standardized tool for preoperative regional lymph node assessment in rectal cancer, showing better diagnostic performance than ESGAR criteria. MRI demonstrates higher diagnostic performance and inter-observer agreement than CT, supporting MRI as the preferred modality.
如何引用
AMA
Yi Cai, Yimin Wang, Ying Tang, Ru Yang, Fubi Hu. A head-to-head comparison of MRI and CT using Node-RADS for rectal cancer lymph nodes: Observer agreement and diagnostic performance.. European journal of radiology open. 2026; doi:10.1016/j.ejro.2026.100763.
APA
Yi Cai, Yimin Wang, Ying Tang, Ru Yang, Fubi Hu (2026). A head-to-head comparison of MRI and CT using Node-RADS for rectal cancer lymph nodes: Observer agreement and diagnostic performance.. European journal of radiology open. https://doi.org/10.1016/j.ejro.2026.100763
GB/T 7714
Yi Cai, Yimin Wang, Ying Tang, Ru Yang, Fubi Hu. A head-to-head comparison of MRI and CT using Node-RADS for rectal cancer lymph nodes: Observer agreement and diagnostic performance.[J]. European journal of radiology open, 2026 doi:10.1016/j.ejro.2026.100763.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出