磁共振弥散加权成像结合常规序列在直肠癌诊断中的应用  

Diffusion Weighted Imaging Combined with Magnetic Resonance Conventional Sequences for the Diagnosis of Rectal Cancer

作　　者：丛冠宁[1] 秦明伟[1] 有慧[1] 李小圳[1] 肖毅[2] 邱辉忠[2] 吴斌[2] 林国乐[2] 孟春玲[1] 孟薇[1] 姜波[1] 刘东[1] 徐进[1] 金阳[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院基本外科,北京100730

出　　处：《中国医学科学院学报》2009年第2期200-205,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨磁共振弥散加权成像(DWI)结合常规序列在直肠癌诊断及分期中的临床价值。方法29例经内镜诊断为直肠癌的患者及15例未患直肠癌的对照组行DWI及磁共振常规序列扫描。两名医师采用盲法阅片诊断。以受试者操作特性曲线(ROC)分析单独使用常规序列及DWI结合常规扫描序列诊断直肠癌的敏感性及特异性。结果单独使用常规序列的ROC曲线下面积分别为0.915和0.930,DWI结合常规序列的ROC曲线下面积分别为0.990和0.994,两种方案均为诊断直肠癌的有效方法。DWI结合常规扫描序列对直肠癌诊断的准确性显著高于单独使用常规扫描序列(P(0.05)。两名医师单独使用常规序列的Kappa值为0.850,采用DWI结合常规扫描序列的Kappa值为0.858。结论DWI是使用常规序列诊断直肠癌的必要补充。Objective To evaluate the clinical value of diffusion weighted imaging （DWI） combined with conventional sequences of magnetic resonance imaging （ T1 and T2-weighted imaging） for the diagnosis of rectal cancer. Methods DWI and conventional sequences were performed in 29 patients with endoscopically diagnosed rectal cancer and 15 patients without rectal cancer. Two doctors who were blind to the history of the patients interpreted the imaging findings. The sensitivity and specificity of conventional sequences with and without DWI were analyzed using receiver operating characteristic curve （ ROC ）. Results The areas under ROC were 0. 915 and 0. 930 for conventional sequences alone, and 0. 990 and 0. 994 for conventional sequences with DWI, respectively, indicating that although both of them were optimal methods for the diagnosis of rectal cancer, the accuracy of conventional sequences with DWI was significantly superior to that of conventional sequence alone （ P 〈 0.05 ）. The value was 0. 850 for conventional sequences alone and 0. 858 for DWI with conventional sequences. Conclusion DWI was necessary for the diagnosis of rectal cancer when performing conventional sequences.

关 键 词：直肠癌 弥散加权成像 影像学诊断 

分 类 号：R574.63[医药卫生—消化系统]