DWIBS对直肠癌淋巴结转移的初步研究  

The preliminary research of DWIBS in lymph node metastasis of rectal cancer

作　　者：刘学焕[1] 刘筠[1] 钟进[1] 许亮[1] 张秀玲[1] 郝彩仙[1] 宗常青[1] 乔辉[1] 

机构地区：[1]天津市人民医院影像学部,天津300121

出　　处：《实用放射学杂志》2014年第11期1839-1841,1854,共4页Journal of Practical Radiology

基　　金：天津市卫生局科技基金（2010KY13,2011KY19）.

摘　　要：目的探讨背景信号抑制扩散加权成像（DWIBS）在直肠癌淋巴结转移诊断中的应用价值。方法30例经肠镜确诊的直肠癌患者行常规MRI及DWIBS检查。对照术后病理结果，确定转移性和非转移性淋巴结。测量淋巴结实质部分的表观扩散系数（ADC）值。比较差异有无统计学意义，采用受试者工作特征曲线（ROC）分析确定ADC值的诊断阈值。结果73枚淋巴结中，转移性淋巴结52枚，非转移性淋巴结21枚。转移性与非转移性淋巴结实质部分的ADC值分别为（0．881±0．094）×10^-3mm^2／s和（1．072±0．108）×10^-3mm^2／s，差异有统计学意义（P〈0．05）。当以ADC=0．957×10^-3mm^2／s作为鉴别转移性与非转移性淋巴结的诊断指标，其诊断价值为优（Az值=0．919，P〈0．05），灵敏度为90．5％，特异度为80．8％。结论ADC值可用于直肠癌淋巴结转移的鉴别，DWIBS在直肠癌淋巴结转移的评估中具有较高的应用价值。Objective To investigate the application value of diffusion-weighted imaging with background suppression （DWIBS） in lymph node metastasis of rectal cancer. Methods 30 patients with rectal cancer diagnosed by colonoscopy underwent routine MRI and DWIBS examinations. Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology. Apparent diffusion coefficient （AOC） values of the solid part of metastatic and non-metastatic lymph nodes were measured and compared. ROC curve analysis was used to define the threshold between the metastatic and non-metastatic lymph nodes. Results In all 73 lymph nodes, there were 52 metastatic lymph nodes and the other 21 were non-metastatic. ADC values of the solid part of metastatic and non-metastatic lymph nodes were （0.881 ± 0.094） × 10^-3 mm^2 /s and （1. 072 ± 0. 108） × 10^-3 mm^2 /s respectively, the difference was statistically significant （P〈0. 05）. With the threshold AOC value of 0. 957 × 10^-3 mm^2/s, the sensitivity and specificity for differentiating metastatic from non-metastatic lymph nodes were 90.5% and 80.8% respectively. The diagnostic value was excellent （Az value = 0. 919,P〈0. 05）. Conclusion AOC values may be used to differentiate lymph node metastasis of rectal cancer, and DWIBS has higher application value in assessing lymph node metastasis of rectal cancer.

关 键 词：背景信号抑制扩散加权成像 表观扩散系数 直肠癌 淋巴结 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]