目的探讨与对比CT与MRI在术 前诊断直肠癌淋巴结转移的价值。方法 2011年7月到2015年2月选择在我院肿瘤科 进行诊治的直肠癌患者78例，在术前都 进行CT与MRI检查，观察CT与MRI的征象 特征并进行分析。结果 78例患者经过手 术病理确诊为淋巴结转移60例(恶性淋巴 结组)，无淋巴结转移18例(良性淋巴结 组)，淋巴结转移发生率为76.9%。CT判定 恶性淋巴结组的CT诊断淋巴结大小、短 长经比值与淋巴结数都明显高于良性淋 巴结组(P<0.05)。MRI显示42例表现为浆 膜面浸润，静脉包绕征54例，肠周脂肪混 杂信号征50例；而良性淋巴结组的分别为 6例，1例与0例，对比差异都有统计学意 义(P<0.05)。与病理判定对比，CT诊断直 肠癌淋巴结转移的敏感性与特异性分别为 100.0%和94.4%，MRI诊断的敏感性与特异 性都为100.0%。结论 CT与MRI征象中的淋 巴结大小、短长径比值、淋巴结数目、浆 膜面浸润、静脉包绕征、肠周脂肪混杂信 号征均可提示提示直肠癌淋巴结转移情 况，诊断特异性与敏感性都比较好。

Objective To investigate and compare the clinical value in CT and MRI in the preoperative diagnosis of lymph node metastasis in colorectal cancer. Methods From July 2011 to February 2015, Selected 78 cases of colorectal cancer patients in our hospital for treatment of oncology, preoperative CT and MRI were performed before oearation, observed the signs characteristics of CT and MRI. Results 78 patients after surgical pathology was confirmed 60 patients of lymph node metastasis (malignant lymph node group), 18 patients without lymph node metastasis (benign lymph node group), the lymph node metastasis rate was 76.9%. The CT diagnosis of lymph node size, short length by the ratio of the number of lymph nodes in the malignant lymph node group were significantly higher than benign group (P<0.05). MRI showed 42 patients were serosal infiltration, intravenous surrounding levy were 54 patients and 50 patients were intestinal fat mixed signals; and benign lymph node group were respectively 6 patients, 1 patient and 0 patient, the differences were statistically significant compared between the two groups (P<0.05). And pathological determination contrast, CT diagnosis of colorectal cancer lymph node metastasis of sensitivity and specificity were 100% and 94.4%, MRI diagnostic sensitivity and specificity were all 100.0%. Conclusion CT and MRI findings in the size of lymph nodes, short diameter ratio, the number of lymph nodes, serosa infiltration, intravenous surrounding syndrome, intestinal fat mixed signal levy week are all available Tip colorectal cancer lymph node metastasis, and the diagnostic specificity and sensitivity all were relatively well.