MRI联合血清CA199在直肠癌肝转移诊断中的应用价值分析  

Analysis of practical value of MRI combined with serum CA199 in the diagnosis of liver metastasis of rectal cancer

作　　者：艾琦[1] 高宏波[1] 刘薇 翁文采[1] AI Qi;GAO Hong-bo;LIU Wei(Department of Radiology,Xinhua Hospital Affiliated to Dalian University,Dalian 116021,China)

机构地区：[1]大连大学附属新华医院放射线科,116021

出　　处：《中国实用医药》2021年第11期64-66,共3页China Practical Medicine

摘　　要：目的分析磁共振成像(MRI)联合血清糖类抗原199(CA199)在直肠癌肝转移诊断中的应用价值。方法 80例直肠癌患者,根据术后6个月切除物病理检查结果不同分为转移组(46例,有肝转移)和未转移组(34例,无肝转移)。两组患者术前均行MRI检查及血清CA199检测。观察两组的影像学特征;比较两组表观弥散系数(ADC)值及CA199水平;比较分析MRI、CA199单独及联合检测对直肠癌肝转移的敏感度、特异度及准确度。结果未转移组患者MRI检查显示病灶呈椭圆形或类圆形,T1WI呈等信号,均匀;T2WI呈稍高信号,均匀且边缘光整;DWI呈稍高或高信号, ADC呈稍低或等信号。转移组患者MRI显示T1WI呈稍低或等信号, T2WI呈稍高或等信号,边缘呈分叶状或毛刺状,不均匀,DWI明显高信号, ADC低信号。转移组患者ADC值低于未转移组, CA199水平高于未转移组,差异具有统计学意义(P<0.05)。MRI联合CA199检查对直肠癌肝转移的敏感度93.48%、特异度94.12%及准确度93.75%均高于MRI单独检查的73.91%、70.59%、72.50%和CA199单独检查的60.87%、61.76%、61.25%,差异具有统计学意义(P<0.05)。结论 MRI联合血清CA199检查对直肠癌肝转移具有更高的诊断价值,可为临床诊疗提供依据。Objective To analyze the practical value of magnetic resonance imaging(MRI)combined with serum carbohydrate antigen 199(CA199)in the diagnosis of liver metastasis of rectal cancer.Methods A total of 80 rectal cancer patients were divided into metastasis group(46 cases,with metastasis)and non-metastasis group(34 cases,without metastasis)according to different pathological examination results of the resected objects 6 months after the operation.Both groups underwent MRI and serum CA199 examination before operation.The imaging characteristics of the two groups were observed.The apparent diffusion coefficient(ADC)value and CA199 level were compared between the two groups,and the sensitivity,specificity and accuracy of MRI and CA199 alone and combined detection of rectal cancer liver metastasis were compared and analyzed.Results MRI examinations of patients in the non-metastasis group showed that the lesions were oval or round,T1WI showed iso-signal,uniform;T2WI showed slightly high signal,uniform and edge-sharp;DWI showed slightly higher or higher signal,ADC showed slightly lower or iso-signal.In the metastasis group,MRI showed slightly low or isosignal on T1WI,slightly high or iso-signal on T2WI,lobulated or burred edge,uneven,high signal on DWI and low signal on ADC.The ADC value of the metastatic group was lower than that of the non-metastatic group,and the CA199 level was higher than that of the non-metastatic group,and the difference was statistically significant(P<0.05).The sensitivity 93.48%,specificity 94.12%and accuracy 93.75%of MRI combined with CA199 to liver metastasis of rectal cancer were higher than MRI[73.91%,70.59%,72.50%]and CA199[60.87%,61.76%,61.25%]alone,and the difference was statistically significant(P<0.05).Conclusion Combination of MRI and serum CA199 has higher diagnostic value for liver metastasis of rectal cancer,which can provide basis for clinical diagnosis and treatment.

关 键 词：直肠癌 肝转移 磁共振成像 血清糖类抗原199 诊断 

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]