高分辨磁共振ADC值与中低分化直肠腺癌的相关性探讨  

Study on the Correlation between ADC Value of High Resolution MRI with Middle-Low Differentiated Rectal Cancer

作　　者：郑欣 唐秋 周慧 赵一蓉[2] 文明[3] ZHENG Xin;TANG Qiu;ZHOU Hui;ZHAO Yi-rong;WEN Ming(Chongqing Tongnan Hospital of Traditional Chinese Medical,Chongqing 402660,China;Chongqing Traditional Chinese Medicinehospital,Chongqing 400021,China;The first Affiliated hHospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆市潼南区中医院放射科,重庆402660 [2]重庆市中医院放射科,重庆400021 [3]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国CT和MRI杂志》2023年第7期145-146,150,共3页Chinese Journal of CT and MRI

基　　金：重庆市潼南区2021年区级实施项目;磁共振扩散加权成像联合动态增强扫描对直肠癌术前分期的价值(TK-2021-18)。

摘　　要：目的探讨磁共振ADC值与中低分化直肠癌的相关性。方法回顾性分析经病理证实并在我院行MR检查的中低分化直肠腺癌患者42例,其中中分化组31例,低分化组11例。对病灶的ADC值测量,设计了参考增强图像法及直接测量法,并分析其诊断效能。结果两种方法测量病灶ADC值的一致性均好,测量的中、低分化直肠腺癌ADC值间,均存在统计差异,其中参考增强图像法所得ADC值选择0.898×10^(-3)mm^(2)/s为阈值,其线下面积(AUC)为0.843,敏感性和特异性分别为93.55%和81.82%;直接测量法所得ADC值选择1.030×10^(-3)mm^(2)/s为最佳诊断截点,其线下面积(AUC)为0.749,敏感性和特异性分别为96.77%和63.64%。结论利用两种方法测量的ADC值,均可应用于中低分化直肠癌的术前病理类型判断,并与直肠癌分化程度有较好的相关性,而参考增强图像法更佳。Objective To investigate the correlation between the ADC value of magnetic resonance imaging and the pathological characteristics of middle and low differentiated rectal cancer.Methods 42 patients with low and medium differentiated rectal adenocarcinoma confirmed by pathology and examined by MR in our hospital were analyzed retrospectively,including 31 cases in the medium differentiated group and 11 cases in the low differentiated group.When measuring ADC value,two different ADC value measurement methods are designed according to whether the enhanced image is referred or not.The ADC value of the lesion obtained by using two different ADC value measurement methods is compared,and its diagnostic efficiency is analyzed.Results there were statistical differences between ADC values of moderately and poorly differentiated rectal adenocarcinoma measured by the two methods(P<0.01).The ADC value obtained by referring to the enhanced image method is 0.898×10^(-3)mm^(2)/s is the threshold.At this time,its offline area(AUC)is 0.843,and its sensitivity and specificity are 93.55%and 81.82%respectively.ADC value obtained by direct measurement method is 1.030×10^(-3)mm^(2)/s is the best cut-off point for diagnosis.At this time,its offline area(AUC)is 0.749,and its sensitivity and specificity are 96.77%and 63.64%respectively.At the same time,the consistency of ADC values measured by the two methods is good.Conclusion The ADC value measured by the two methods can be applied to the preoperative pathological type analysis of low and medium differentiated rectal cancer,and has a good correlation with the differentiation degree of rectal cancer;It is better to refer to the enhanced image method.

关 键 词：磁共振 ADC值 直肠腺癌 病理类型 

分 类 号：R445.2[医药卫生—影像医学与核医学]