Diagnostic value of different evaluation systems based on MRI for rectal cancer lymph node metastasis

HUANG Zhiping; YU Zhujuan; LIN Bomiao; LI Jing; WANG Baoan

doi:10.20258/j.cnki.1006-9011.2025.12.020

Abstract：Objective The aim of this study was to investigate the diagnostic value of different imaging evaluation systems in the preoperative assessment of rectal mesenteric lymph node metastasis(LNM)in rectal cancer.Methods 102 patients with rectal cancer were selected and divided into non metastatic group(59 cases)and metastatic group(43 cases)according to post-operative pathological examination results.MRI examination was performed on both groups,and imaging evaluation indicators in terms of lymph node diameter,Node RADS score,and ESGAR classification,morphological prediction were obtained based on MRI images.ROC curves were used to analyze the diagnostic value of different imaging indicators for lymph node metastasis in rectal cancer.Results The comparison of lymph node short diameter,Node RADS score,ESGAR classification,and morpho-logical prediction between the two groups before treatment showed P<0.05.In the preoperative prediction of pN+status,the diag-nostic performance of short-axis lymph node diameter yielded an AUC of 0.739,with a sensitivity and specificity of 72.1%and 67.8%,respectively.The Node-RADS score demonstrated the highest diagnostic efficacy,with an AUC of 0.876,coupled with a sensitivity of 83.7%and a specificity of 86.4%.The ESGAR classification achieved an AUC of 0.800,with a sensitivity of 65.1%and a specificity of 94.9%.Meanwhile,the morphological prediction showed an AUC of 0.745,with a sensitivity and specificity of 74.4%and 74.6%,respectively.Conclusions The Node-RADS score demonstrated superior diagnostic performance for pre-dicting lymph node metastasis(LNM)in rectal cancer compared to the short-axis diameter and morphological prediction,achiev-ing high sensitivity and specificity.