多b值DWI联合MRI常规扫描对直肠癌检查图像质量的影响  

Effect of Multi-b-value DWI Combined with Conventional MRI Scanning on Image Quality of Rectal Cancer

作　　者：刘玉霞[1] 谢瑞峰[1] 胡延涛[1] LIU Yuxia;XIE Ruifeng;HU Yantao(Puyang People’s Hospital,Puyang,457000)

机构地区：[1]河南省濮阳市人民医院,457000

出　　处：《实用癌症杂志》2021年第7期1111-1115,共5页The Practical Journal of Cancer

摘　　要：目的观察多弥散加权系数(b)值磁共振扩散加权成像(DWI)联合核磁共振成像(MRI)常规扫描对直肠癌检查图像质量的影响。方法回顾分析96例直肠癌患者资料,分析患者MRI常规扫描、多b值DWI检查的图像质量,以手术后病理检查结果为金标准,评估MRI常规扫描、b=800 s/mm^(2)时DWI检查对患者肿瘤分期的诊断价值;比较低、中、高分化病灶在多b值下对应的表观扩散系数(ADC)值。结果b=800 s/mm^(2)时DWI图像质量评分最低,不同检查方法间图像质量评分比较,差异均有统计学意义(P<0.05)。手术后病理检查结果显示,96例直肠癌患者中,有26例T2期,53例T3期,17例T4期;MRI常规扫描与手术病理结果的一致性一般(Kappa=0.681),b=800 s/mm^(2)时DWI检查联合MRI常规扫描检查与手术后病理检查结果的一致性好(Kappa=0.840)。在多b值下,高分化组ADC值最高,后由高到低依次为中分化组、低分化组,不同分化程度肿瘤对应的ADC值比较,差异均有统计学意义(P<0.05)。结论b=800 s/mm^(2)时DWI检查的图像质量较好,联合MRI常规扫描对肿瘤分期有较高诊断价值,多b值DWI联合MRI常规扫描还有助于进一步评估患者肿瘤分化程度。Objective To observe the effect of multiple diffusion weighted coefficient(b)value diffusion weighted imaging(DWI)combined with conventional magnetic resonance imaging(MRI)on the image quality of rectal cancer.Methods The data of 96 patients with rectal cancer were retrospectively analyzed,the image quality of patients with conventional MRI scan and multi-b-value DWI was analyzed,the results of postoperative pathological examination were taken as the gold standard,the diagnostic value of conventional MRI scan and DWI at b=800 s/mm^(2) for tumor staging of patients was evaluated;the apparent diffusion coefficient(ADC)values of low,medium and high differentiated lesions were compared under multiple b values.Results When b=800s/mm^(2),DWI image quality score was the lowest,compared image quality scores among different examination methods,the differences were all statistically significant(P<0.05);the results of postoperative pathological examination showed that among 96 patients with rectal cancer,there were 26 cases with T2 stage,53 cases with T3 stage and 17 cases with T4 stage;routine MRI scan had general agreement with surgical pathology results(Kappa=0.681),when b=800 s/mm^(2),the results of DWI combined with MRI had good consistency with postoperative pathological examination(Kappa=0.840).Under multiple b values,the ADC value of well differentiation group was the highest,and then from high to low was medium differentiation group and low differentiation group,compared ADC values of different differentiated tumors,the differences were all statistically significant(P<0.05).Conclusion The image quality of DWI is better when b=800s/mm^(2),it has higher diagnostic value for tumor staging with the combination of conventional MRI scanning,the combination of multi-b-value DWI and MRI is also helpful to evaluate the degree of tumor differentiation.

关 键 词：直肠癌 核磁共振成像 磁共振扩散加权成像 图像质量 分期 分化 

分 类 号：R735.37[医药卫生—肿瘤]