目的：探讨 MRI 用于超低位直肠癌行机器人辅助保肛手术的可行性和手术时机选择等方面的预测价 值。方法：回顾性分析南京中医药大学附属医院 2021 年 1 月—2023 年 5 月收治的超低位直肠癌行机器人辅助手术 的 37 例患者临床资料，均于术前完成 MRI 平扫 + 增强检查，记录患者一般情况、手术方式及术后病理资料，以术 后病理为金标准，分析术前 MRI 检查 T 分期、N 分期、肠壁外血管侵犯和直肠系膜筋脉累及等情况，评价术前 MRI 对于超低位直肠癌行机器人辅助保肛手术的可行性和手术时机选择等方面的预测价值。结果：以术后病理为金标准， 基于 MRI 检查 T 和 N 分期准确率分别为 86.49%、75.68%，差异无统计学意义（P>0.05）。术前 MRI 预测肠壁外血 管侵犯和直肠系膜筋脉累及准确率分别为 67.57%、89.19%，差异无统计学意义（P>0.05）。结论：术前 MRI 对超 低位直肠癌行机器人辅助保肛手术的可行性预测、手术时机选择及制定合理诊疗方案具有重要意义。

Objective: To explore the predictive value of MRI in the feasibility and surgical timing selection of robotassisted anus-preserving surgery for ultra-low rectal cancer. Methods: Clinical data of 37 patients in the Affiliated Hospital of Nanjing University of Chinese Medicine who underwent robot-assisted surgery for ultra-low rectal cancer from January 2021 to May 2023 was retrospectively analyzed. MRI plain scan and enhanced examination were performed on all patients before surgery, and their general conditions, surgical methods and postoperative pathological data were recorded. The T-stage, N-stage, extramural vascular invasion (EMVI), and involvement of mesorectal fascia in preoperative MRI examinations were analyzed to evaluate the predictive value of preoperative MRI. Results: Using postoperative pathology as the gold standard, the accuracy of T and N staging based on MRI examination was 86.49% and 75.68% respectively, and the difference was not statistically significant (P>0.05). The accuracy of preoperative MRI in predicting EMVI and mesorectal fascial involvement was 67.57% and 89.19% respectively, and the difference was not statistically significant (P>0.05). Conclusion: Preoperative MRI is of great significance in predicting the feasibility and surgical timing selection of robot-assisted anus-preserving surgery for ultra-low rectal cancer, which could help to develop a reasonable diagnosis and treatment plan.

收稿日期：2023-12-04  录用日期：2023-12-19 

Received Date: 2023-12-04  Accepted Date: 2023-12-19 

基金项目：江苏省医学重点学科建设项目（ZDXK202251） 

Foundation Item: Key Medical Discipline Construction Project of Jiangsu Province(ZDXK202251) 

通讯作者：刘江，Email：doctorliujiang@126.com 

Corresponding Author: LIU Jiang, Email: doctorliujiang@126.com

 引用格式：周长顺，夏存冰，柳欣欣，等 . MRI 对超低位直肠癌行机器人辅助保肛手术的预测价值分析 [J]. 机器人外科学杂志（中 英文），2024，5（6）：1217-1220. 

Citation: ZHOU C S, XIA C B, LIU X X, et al. Predictive value of MRI in robot-assisted anus-preserving surgery for ultra-low rectal cancer[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1217-1220.

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