目的 通过腔内超声（transrectal ultrasonography，TRUS）及磁共振（magnetic resonance imaging， MRI）明确直肠癌的 TN 分期，比较术前 TRUS 与 MRI 对局部进展期直肠癌（locally advanced rectal cancer， LARC）的诊断准确性。方法 收集 2019 年 5 月至 2021 年 12 月于我院确诊直肠癌并在手术治疗前行 TRUS 及MRI检查的159例患者，以术后病理分期为金标准，回顾性分析TRUS及MRI对直肠癌TN分期的准确性，比 较两者对 LARC 的诊断价值。 结果 TRUS 及 MRI 对直肠癌 T 分期的准确率分别为 83.02%、82.40%，均与 术后病理分期一致性较高，Kappa 值分别为 0.73、0.72，差异有统计学意义（P < 0.05）；在 T 分期各期准确 性中，MRI对T4期病变的灵敏度显著优于TRUS，差异有统计学意义（P < 0.05）。TRUS对N分期的准确率、灵 敏度、特异度分别为 81.13%、79.73%、82.35%，MRI 对 N 分期的准确率、灵敏度、特异度分别为 75.47%、 90.54%、63.35%；MRI 的灵敏度优于 TRUS，而 TRUS 的特异度高于 MRI，差异有统计学意义（P < 0.05）。 TRUS 诊断 LARC 的准确率、特异度较 MRI 高，差异有统计学意义（P < 0.05）。结论 TRUS 及 MRI 对直肠 癌 T、N 分期与病理分期有较好的一致性。MRI 在 T4 期病灶的检出优于 TRUS，而 TRUS 对 LARC 的区分优 于MRI，对临床制定个性化治疗方案有一定的指导意义。

Objective To determine the TN staging of rectal cancer by transrectal ultrasonography（TRUS） and magnetic resonance imaging（MRI），and to compare the diagnostic accuracy of preoperative TRUS with that of MRI in detection of locally advanced rectal cancer（LARC）. Methods A total of 159 patients with rectal cancer diagnosed in our hospital from May 2019 to December 2021 who had preoperatively undergone both TRUS and MRI were collected. With postoperative pathological staging as the gold standard，the accuracy of TRUS and MRI in TN staging of rectal cancer was retrospectively analyzed. The diagnostic value of TRUS and MRI for LARC was compared. Results The accuracy rate of TRUS and MRI for T staging of rectal cancer was 83.02% and 82.40%，respectively，consistent with postoperative pathological staging；the Kappa value was 0.73 and 0.72，respectively， with statistical significance（P < 0.05）. For the accuracy of T staging，the sensitivity of MRI for T4 stage lesions was significantly better than that of TRUS，with statistical significance（P < 0.05）. The accuracy，sensitivity and specificity of TRUS for N staging were 81.13%，79.73% and 82.35%；while those of MRI were 75.47%，90.54% and 63.35%，respectively. The sensitivity of MRI was better than that of TRUS，and the specificity of TRUS was higher than that of MRI，with statistical significance（P < 0.05）. The accuracy and specificity of TRUS in the diag⁃ nosis of LARC were higher than those of MRI，with statistical significance（P < 0.05）. Conclusions TRUS and MRI have better consistency in T and N staging and pathological staging of rectal cancer. MRI is superior to TRUS in detection of T4 lesions，whereas TRUS is better than MRI in differentiation of LARC，which has certain guidingsignificance for clinically formulating personalized treatment plans.