3.0T磁共振高分辨联合扩散加权成像对直肠癌局部浸润的诊断价值  

Diagnostic value of 3.0T high resolution magnetic resonance imaging combined with DWI in local invasion of rectal cancer

作　　者：张丽[1] 汤春贵 郝淑彬 李勇[2] 骆俊杰 程维高[1] ZHANG Li;TANG Chun-gui;HAO Shu-bin;LI Yong;LUO Jun-jie;CHENG Wei-gao(Department of Radiology,Yaan People's Hospital,Yaan 625000,China;Department of General Surgry,Yaan People's Hospital,Yaan 625000,China)

机构地区：[1]四川省雅安市人民医院放射科,四川雅安625000 [2]四川省雅安市人民医院普外科,四川雅安625000

出　　处：《中国现代普通外科进展》2021年第1期45-50,共6页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨3.0T磁共振高分辨联合扩散加权成像(DWI)序列对直肠癌鉴别浸润深度的评估价值。方法:回顾性分析2017年3月—2018年10月四川省雅安市人民医院手术的34例直肠癌患者,患者术前均扫描了MRI高分辨序列和DWI序列,以病理学结果为金标准,分别计算单独高分辨MRI和高分辨MRI联合DWI对直肠癌T分期和环周切缘(CRM)诊断的准确度、敏感度、特异度。结果:34例直肠癌术后诊断T1期4例,T2期7例,T3期15例,T4期8例。MRI高分辨成像对直肠癌T1、T2、T3、T4期诊断的准确度分别为94.1%、88.2%、94.1%、94.1%,敏感度分别为50.0%、75.0%、92.9%、87.5%,特异度分别为100%、92.3%、95.0%、95.8%,对CRM评估的准确度、敏感度、特异度分别为85.7%、66.7%、87.5%。高分辨MRI联合DWI序列对直肠癌T1、T2、T3、T4期诊断的准确度分别为94.1%、91.2%、97.1%、100%,敏感度分别为50.0%、87.5%、100%、100%,特异度分别为100%、91.2%、95.0%、100%,对CRM评估的准确度、敏感度、特异度分别为92.8%、71.4%、85.7%。对2种成像方法诊断T分期的准确度、敏感度、特异度比较,高分辨MRI联合DWI较高,但差异无统计学意义(P>0.05)。结论:3.0T磁共振DWI序列是直肠癌分期诊断必要补充序列,可以为直肠癌局部浸润诊断提供更多帮助,为临床选择治疗方式提供依据。Objective:To evaluate the diagnostic value of 3.0 TMR high resolution imaging se quence combined with DWI sequence in differentiating invasion depth of rectal cancer.Methods:34 patients with rectal cancer who were operated from March 2017 to October 2018 were retrospectively analyzed.The high-resolution sequence and DWI sequence were scanned before operation.The accuracy,sensitivity,specificity of simple high-resolution imaging and high-resolution combined DWI imaging for T-staging diagnosis and cirumferential resection margin of rectal cancer were calculated according to the pathological results.Results:34 cases of rectal cancer were diagnosed as stage T1 in 4 cases,stage T2 in 7 cases,stage T3 in 15 cases and stage T4 in 8 cases.The accuracy,sensitivity and specificity of MR high-resolution scanning for T1,T2,T3 and T4 stages of rectal cancer were 94.1%,88.2%,94.1%,94.1%,50%,75.0%,92.9%,87.5%,100%,92.3%,95.0%and 95.8%,respectively.The accuracy,sensitivity and specificity of CRM evaluation were 85.7%,66.7%and 87.5%,respectively.The accuracy of high-resolution MRI combined with DWI sequence in the diagnosis of T1,T2,T3 and T4 of rectal cancer was 94.1%,91.2%,97.1%and 100%,the sensitivity was 50.0%,87.5%,100%,100%,the specificity was 100%,91.2%,95.0%,100%,respectively,and the accuracy,sensitivity and specificity of CRM were 92.8%,71.4%and 85.7%,respectively.There was no significant difference in the accuracy,sensitivity and specificity between the two imaging methods(P>0.05).Conclusion:3.0T MRI DWI sequence is a necessary supplementary sequence for staging diagnosis of rectal cancer,which can provide more help for the diagnosis of local invasion of rectal cancer.High resolution combined with DWI can improve the accuracy of staging diagnosis of rectal cancer and provide basis for clinical selection of treatment methods.

关 键 词：直肠癌 高分辨磁共振成像 DWI成像 T分期 环周切缘 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]