DWI及其ADC值对直肠癌病理分级分型的诊断价值研究  

Diagnostic Value of DWI and Its ADC Values in Grades and Classifications of Rectal Cancer

作　　者：孙海涛 翟跃杰[1] 黄勇华[1] SUN Hai-tao;ZHAI Yue-jie;HUANG Yong-hua(Department of Radiology,Puyang Oilfield General Hospital,Puyang 457001,Henan Province,China)

机构地区：[1]濮阳市油田总医院放射科,河南濮阳457001

出　　处：《中国CT和MRI杂志》2022年第3期156-158,179,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振弥散加权成像(DWI)及其表观弥散系数(ADC)值对直肠癌分级分型诊断的应用价值。方法回顾性分析2016年11月至2019年11月于我院就诊的80例直肠癌患者临床资料,均有完整的术前DWI影像资料。以术后病理结果为“金标准”,采用受试者工作特征(ROC)曲线评价ADC值鉴别直肠癌不同分型和分级的诊断效能。结果80例直肠癌患者中,病理证实直肠黏液腺癌14例(17.50%),直肠腺癌66例(82.50%);黏液腺癌组ADC值显著高于腺癌组(P<0.05);黏液腺癌组ADC值显著高于高、中、低分化腺癌组(均P<0.05),直肠腺癌ADC值随着分化程度降低而降低(均P<0.05);ROC曲线分析结果显示,ADC值鉴别直肠黏液腺癌与直肠腺癌的最佳临界值为1.18×10^(-3)mm^(2)/s,ROC曲线下面积(AUC)为0.834(95%CI:0.757~0.894);ADC值鉴别高分化与中、低分化直肠腺癌的最佳临界值为0.98×10^(-3)mm^(2)/s,AUC为0.722(95%CI:0.636~0.798)。结论DWI及其ADC值有助于鉴别直肠黏液腺癌与不同分化程度的直肠腺癌,具有较好的应用价值。Objective To explore the application of magnetic resonance diffusion-weighted imaging(DWI)and its apparent diffusion coefficient(ADC)in the grading and classifications of rectal cancer.Methods A retrospective analysis was performed on the clinical data of 80 patients with rectal cancer who were treated in the hospital from November 2016 to November 2019.There were complete preoperative DWI imaging data in all of them.The diagnostic efficiency of ADC values in identifying different classifications and grades of rectal cancer was assessed by ROC curves while using pathological results as"golden standard".Results Among the 80 patients with rectal cancer,there were 14 cases(17.50%)with rectal mucinous adenocarcinoma and 66 cases(82.50%)with rectal adenocarcinoma confirmed by the pathology.ADC value of the mucinous adenocarcinoma group was higher than the adenocarcinoma group(P<0.05).ADC value of the mucinous adenocarcinoma group was higher than the highly,moderately and poorly differentiated adenocarcinoma group,respectively(P<0.05).ADC value of rectal adenocarcinoma was decreased as the decrease of differentiation degree(P<0.05).The results of ROC curve analysis showed that best cut-off value and the area under the ROC curve(AUC)of ADC values for identifying rectal mucinous adenocarcinoma and rectal adenocarcinoma were 1.18×10^(-3)mm^(2)/s and 0.834(95%CI:0.757 to 0.894),respectively.The best cut-off value and AUC of ADC values for identifying highly,moderately and poorly differentiated rectal adenocarcinoma were 0.98×10^(-3)mm^(2)/s and 0.722(95%CI:0.636 to 0.798),respectively.Conclusion DWI and its ADC values are conductive to identifying rectal mucinous adenocarcinoma and rectal adenocarcinoma with different differentiation degree,which are of good application value.

关 键 词：直肠癌 弥散加权成像 病理分型 分化程度 

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