DCE-MRI联合DWI对直肠癌患者术前T、N分期及系膜淋巴结良恶性的诊断价值  

The Diagnostic Value of DCE-MRI Combined with DWI in Preoperative T,N Stages and Mesenteric Lymph Nodes of Patients with Rectal Cancer

作　　者：刘静[1] 丁伟[1] 陈丽君[1] 罗莎 王彤[2] LIU Jing;DING Wei;CHEN Li-jun;LUO Sha;WANG Tong(Department of Radiology,Benxi Central Hospital Affiliated to China Medical University,Benxi,L iaoning,117000,China;Department of Radiology,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning,110000,China)

机构地区：[1]中国医科大学附属本溪中心医院放射科,辽宁本溪117000 [2]中国医科大学附属盛京医院放射科,辽宁沈阳110000

出　　处：《现代生物医学进展》2020年第23期4505-4509,共5页Progress in Modern Biomedicine

基　　金：辽宁省科学技术计划项目(2015226347)。

摘　　要：目的:探讨动态对比增强磁共振(DCE-MRI)联合弥散加权成像(DWI)诊断直肠癌术前T、N分期和系膜淋巴结良恶性的价值。方法:收集2017年2月至2019年10月中国医科大学附属本溪中心医院和中国医科大学附属盛京医院接诊的80例直肠癌患者,均进行常规核磁共振成像(MRI)、DCE-MRI、DWI扫描,获得DCE-MRI、DWI定量参数[转运常数(Ktrans)、细胞外血管外空间的体积分数(Ve)、速率常数(Kep)、表观扩散系数(ADC)],比较不同T、N分期、不同性质系膜淋巴结DCE-MRI、DWI参数,及其对T、N分期和系膜淋巴结性质的诊断效能。结果:直肠癌癌灶Ktrans、Kep、Ve高于正常肠壁,ADC低于正常肠壁(P<0.05)。TNM分期为TⅢ~Ⅳ期的患者Ktrans、Kep、Ve高于TⅠ~Ⅱ期,ADC低于TⅠ~Ⅱ期(P<0.05);TNM分期为N1期的患者Ktrans、Kep、Ve高于N0期,ADC低于N0期(P<0.05)。联合诊断的灵敏度、特异度、阳性预测值、阴性预测值较高。结论:DCE-MRI联合DWI对直肠癌术前T、N分期、系膜淋巴结性质诊断价值较高。Objective: To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) combined with diffusion-weighted imaging(DWI) in the diagnosis of preoperative TN stage and benign and malignant mesenteric lymph nodes.Methods: 80 patients with rectal cancer who were received by Benxi Central Hospital Affiliated to China Medical University and Shengjing Hospital Affiliated to China Medical University from February 2017 to October 2019 were selected, they were scanned with conventional Magnetic resonance imaging(MRI), DCE-MRI and DWI to obtain the quantitative parameters of DCE-MRI and DWI[transfer constant(Ktrans), extravascular extracellular volume fraction(Ve), rate constant of backflux(Kep) and apparent diffusion coefficient(ADC)]. DCE-MRI and DWI parameters of different T, N stages and different properties of mesenteric lymph nodes were compared, and its diagnostic efficacy in T, N stages and properties of mesenteric lymph nodes. Results: The levels of Ktrans, Kepand Vein rectal cancer were higher than that in normal intestinal wall, and ADC was lower than that in normal intestinal wall(P<0.05). The levels of Ktrans, Kep and Vein TⅢ-Ⅳ, N1 and mesangial malignant lymph nodes were higher than that in TⅠ~Ⅱ group, N0 group and mesangial benign lymph node group(P<0.05), the levels of Ktrans, Kep, Ve in patients with TNM stage N1 were higher than that in patients with N0, and ADC was lower than that in patients with N0(P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of combined diagnosis were higher. Conclusion: DCE-MRI combined with DWI is of high value in the preoperative diagnosis of T, N stage and mesenteric lymph nodes of rectal cancer.

关 键 词：动态对比增强磁共振 弥散加权成像 结肠癌 T分期 N分期 淋巴结 

分 类 号：R735.37[医药卫生—肿瘤]