2D TSE与3D SPACE序列对直肠癌术前T分期的诊断价值比较  

Comparison on Diagnostic Value of 2D TSE and 3D SPACE Sequence in Preoperative T Staging in Patients with Rectal Cancer

作　　者：马文帅[1] 高远翔[1] 高耸[1] 郝小磊[1] 冯卫华[1] MA Wenshuai;GAO Yuanxiang;GAO Song;HAO Xiaolei;FENG Weihua(Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao 266555,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266555

出　　处：《中国医学影像学杂志》2022年第9期903-908,共6页Chinese Journal of Medical Imaging

摘　　要：目的比较三维可变翻转角各向同性快速自旋回波(3D SPACE)序列与传统二维快速自旋回波(2D TSE)序列对直肠癌术前T分期的诊断价值。资料与方法选取2018年1月—2019年12月青岛大学附属医院收治的直肠癌患者75例,术前进行2D TSE及3D SPACE序列扫描,计算2D TSE及3D SPACE序列图像的信噪比(SNR)、对比噪声及图像评分评估图像质量。以术后病理结果为“金标准”,比较2D TSE及3D SPACE序列诊断直肠癌术前T分期的准确度。结果2D TSE和3D SPACE序列的图像质量在显示直肠浆膜层或外膜[3.00(2.00,3.00)比3.00(3.00,3.00);Z=−0.16,P=0.990]、肠周脂肪[3.00(3.00,3.00)比3.00(3.00,3.00);Z=−0.259,P=0.800]、直肠系膜筋膜[3.00(3.00,3.00)比3.00(3.00,3.00);Z=−1.27,P=0.210]、瘤体[3.00(3.00,3.00)比3.00(3.00,3.00);Z=−0.03,P=0.990]比较,差异无统计学意义。3D SPACE序列在显示直肠黏膜层[3.00(2.00,3.00)比3.00(3.00,3.00);Z=−2.47,P=0.013]、直肠肌层[3.00(2.00,3.00)比3.00(3.00,3.00);Z=−3.21,P=0.001]方面图像质量更高。对于瘤体,3D SPACE序列的SNR优于2D TSE序列(119.95±39.83比83.94±40.34;t=−2.54,P=0.016);对于脂肪(213.56±95.26比191.22±59.47;t=0.80,P=0.430)及肌肉(41.86±19.34比40.40±15.58;t=0.24,P=0.820),2D TSE及3D SPACE序列的SNR差异无统计学意义;两序列对比噪声比差异无统计学意义(19.36±10.11比27.54±18.72;t=−1.54,P=0.140)。与术后病理结果对比,2D TSE序列的诊断一致性(Kappa=0.49,P=0.00)比3D SPACE序列低(Kappa=0.95,P=0.000),两序列对T分期的诊断准确度分别为76.00%和98.67%。结论2D TSE和3D SPACE序列显示直肠浆膜层或外膜、肠周脂肪、直肠系膜筋膜及瘤体一样可靠。3D SPACE序列对于显示直肠黏膜层及直肠肌层较2D TSE序列更优越。对于直肠癌的术前T分期,3D SPACE序列较传统高分辨2D TSE序列的诊断准确度更高,可更好地为临床制订治疗方案提供影像学依据。Purpose To compare the diagnostic value of three-dimensional variable rotation angle isotropic fast spin echo(3D SPACE)sequence and traditional two-dimensional fast spin echo(2D TSE)sequence in preoperative T staging in patients with rectal cancer.Materials and Methods A total of 75 patients with rectal cancer who were treated in the Affiliated Hospital of Qingdao University from January 2018 to December 2019 were retrospectively selected.All patients underwent 2D TSE and 3D SPACE sequence scans before surgery.Image quality was evaluated by calculating the signal noise ratio(SNR),contrast noise ratio and image score of 2D TSE and 3D SPACE sequence images.The postoperative pathological results were taken as the gold standard,and the accuracy of 2D TSE and 3D SPACE sequences in diagnosing preoperative T staging of rectal cancer was further compared.Results The Image quality scores were as follows:there were no statistical difference in rectal serosa or rectal adventitia[3.00(2.00,3.00)vs.3.00(3.00,3.00);Z=−0.16,P=0.990],perirectal fat[3.00(3.00,3.00)vs.3.00(3.00,3.00);Z=−0.259,P=0.800],mesorectal fascia[3.00(3.00,3.00)vs.3.00(3.00,3.00);Z=−1.27,P=0.210],tumor[3.00(3.00,3.00)vs.3.00(3.00,3.00);Z=−0.03,P=0.990]between 2D TSE and 3D SPACE sequences.Rectal mucosa[3.00(2.00,3.00)vs.3.00(3.00,3.00);Z=−2.47,P=0.013],rectal muscularis propria[3.00(2.00,3.00)vs.3.00(3.00,3.00);Z=−3.21,P=0.001]in 3D SPACE sequence were statistically better than those in 2D TSE sequence.For tumors,the SNR of 3D SPACE sequences were significantly superior to that of 2D TSE(119.95±39.83 vs.83.94±40.34;t=−2.54,P=0.016).However,for fat(213.56±95.26 vs.191.22±59.47;t=0.80,P=0.430)and muscle(41.86±19.34 vs.40.40±15.58;t=0.24,P=0.820),there were no statistical difference in SNR between 2D TSE and 3D SPACE sequences.There were no statistical difference in contrast noise ratio between 2D TSE and 3D SPACE sequences(19.36±10.11 vs.27.54±18.72;t=−1.54,P=0.140).Compared with postoperative pathological results,the diagnostic consist

关 键 词：直肠癌 术前分期 磁共振成像 2D TSE序列 3D SPACE序列 图像质量 

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