核磁高b值扩散加权成像与扩散张量成像在大肠腺癌中的应用价值  

The Application of Diffusion-weighted Imaging with High b Value and Diffusion Tensor Imaging in Colorectal Adenocarcinoma

作　　者：张秀萍 彭澍 王习 何杰 周维 Zhang Xiuping;Peng Shu;Wang Xi;He Jie;Zhou Wei(Department of Radiology,Changsha Third Hospital,Changsha,Hunan 430015)

机构地区：[1]长沙市第三医院放射影像科,湖南长沙430015

出　　处：《现代医用影像学》2021年第3期412-415,共4页Modern Medical Imageology

基　　金：长沙市科技局立项课题,项目编号:kq1706003。

摘　　要：目的:探讨高b值DWI及DTI在结、直肠中、高分化腺癌中的诊断价值。方法:收集我院结、直肠癌高度怀疑患者,所有患者均接受1.5TMRIDWI及DTI扫描,测量DWI中的ADC值及DTI中的FA值,结果与病理结果进行对照。结果:中分化腺癌与高分化腺癌的ADC值分别为0.000907±0.000168、0.000984±0.000164。中分化腺癌与高分化腺癌的FA值分别为0.173±0.032,0.236±0.026。两者对比均有统计学意义(p<0.05)。ROC曲线分析中,ADC值和FA值的诊断效能分别为64.5%、92.6%,且有明显统计学意义。利用ADC值诊断中、高分化腺癌的灵敏度及特异度分别为49%及93%,诊断界值为0.996×10^(-3)mm^(2)/s, ROC曲线下面积AUC为0.645;利用FA值诊断中、高分化腺癌的灵敏度及特异度分别为93%及94%,诊断界值约0.202,ROC曲线下面积AUC为0.926。结论:核磁高b值DWI及DTI在大肠中、高分化腺癌中有诊断价值,并且FA值的诊断效能较高,对临床诊治有一定帮助。Objective:To explore the diagnostic value of high b-value DWI and DTI in middle and high differentiated adenocarcinoma of the colon and rectum.Methods:Collecting highly suspected patients of colorectal cancer in our hospital, all patients were scanned with 1.5 t MRI DWI and DTI, ADC and FA were measured, and the results were compared with pathological results.Results:The ADC values of moderately and highly differentiated adenocarcinoma were 0.000907 ± 0.000168 and 0.000984 ± 0.000164, respectively. The FA values of moderately and highly differentiated adenocarcinoma were 0.173 ± 0.032 and 0.236 ± 0.026, respectively. There was statistical significance between the two groups(P<0.05). In ROC curve analysis, the diagnostic efficacy of ADC value and FA value were 64.5% and 92.6%, respectively, with significant statistical significance. The sensitivity and specificity of ADC were 49% and 93%, in diagnosis of moderately differentiated and well differentiated adenocarcinoma, The diagnostic boundary value is 0.996×10^(-3)mm^(2)/s. the AUC area in ROC curve is 0.645.The sensitivity and specificity of FA were 93% and 94%, respectively. The diagnostic threshold was about 0.202, and the area under ROC curve was 0.926. Conclusions:DWI with high b value and DTI are valuable in the diagnosis of colorectal moderately differentiated and well differentiated adenocarcinoma, and FA value is of high diagnostic efficiency, which is helpful for clinical diagnosis and treatment.

关 键 词：结肠 直肠 DWI DTI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.34[医药卫生—诊断学]