磁共振弥散加权成像在直肠癌术前评估的应用价值  

Application of diffusion-weighted imaging in preoperative evaluation of rectal cancer

作　　者：刘军[1] LIU Jun(First People＇s Hospital of Changde, Changde 415003, China)

机构地区：[1]常德市第一人民医院,湖南常德415003

出　　处：《临床医药实践》2017年第6期446-449,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨核磁共振直肠成像结合增强扫描技术诊断直肠肿瘤的临床应用价值。方法:选择门诊诊查的60例经纤维电子结直肠镜诊断为直肠癌的患者,所有患者行核磁共振常规序列及弥散加权成像(DWI)扫描,结果采用双盲法判读。对60例直肠癌患者进行MRI术前影像T、N分期,患者都在行结肠癌手术治疗后取组织验证,术后标本采用世界癌症学会(WJCC)的标准进行评判,通过统计学软件对病理及影像学的淋巴结分期、肿瘤分期进行统计分析。结果:统计学分析结果显示60例直肠癌患者中病理学和MRI一致性较好(Kappa=0.893,P=0.000),术前MRI的T分期正确52例,过高分期4例,过低分期4例;统计学分析结果显示病理学和MRI对N分期一致性中等(Kappa=0.452,P=0.000),术前MRI的N分期正确例数有49例,过高分期6例,过低分期5例。结论:应用核磁共振成像联合DWI技术诊断直肠癌及进行术前分期具有很好的前景及重要的临床价值。MRI联合DWI呈现的结果直观、具体,能显示直肠癌的具体特点和相应部位,可以明显提高对直肠癌的检出率。MRI联合DWI技术对直肠癌术前T、N分期都有较好的准确性。Objective ： To find the clinical application of 1 of diffusion - weighted imaging in preoperative evaluation of rec- tal cancer. Methods ： A total of 60 cases by fiber optic eolonoscopy diagnosis with rectal cancer as the object of study. All patients underwent magnetic resonance imaging and DWI scan, and two doctors were diagnosed by double blind method. The 60 cases in our hospital for examination of colorectal cancer patients with preoperative MRI imaging, patients in the surgical treat- ment of colon cancer tissue after verification. The world cancer society with postoperative specimens were evaluated by standard statistical software for pathological and imaging lymph node staging. Results ： Statistical analysis showed that 60 patients with rectal cancer in pathology and MRI good consistency （ Kappa = 0.893, P = 0. 000）, preoperative MRI T staging was accurate in 52 cases, understaged 4 cases,4 cases of low stage;statistical analysis showed that pathological N staging and MRI of medium consistency （ Kappa = O. 452, P = 0.000）, preoperative MRI N correctly staged cases 49 cases, understaged 6 cases,5 cases of low stage. Conclusion：Clinical application of magnetic resonance imaging combined with DWI technology in the diagnosis of rectal cancer and preoperative staging has a good prospect and important clinical value. The results of DWI showed the specific characteristics of rectal cancer and the corresponding parts, which can significantly improve the detection rate of rectal cancer. MRI combined with DW! technology for preoperative N and T staging of rectal cancer has good accuracy.

关 键 词：弥散加权成像 直肠癌 磁共振成像 

分 类 号：R735.37[医药卫生—肿瘤]