小视野高清扩散加权MRI技术在直肠癌检测中的价值  

The value of high-resolution small field-of-view diffusion-weighted MRI technique in the detection of rectal cancer

作　　者：吴冰杰 刘颖 张宇威 张宏钰 刘嘉[2] 叶兆祥 WU Bingjie;LIU Ying;ZHANG Yuwei;ZHANG Hongyu;LIU Jia;YE Zhaoxiang(Department of Radiology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China;Department of Colorectal Oncology,Tianjin Medical University Cancer Institute and Hospital)

机构地区：[1]天津医科大学肿瘤医院放射科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津300060 [2]天津医科大学肿瘤医院结直肠肿瘤科

出　　处：《国际医学放射学杂志》2023年第6期634-638,658,共6页International Journal of Medical Radiology

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)。

摘　　要：目的探讨基于缩放成像技术(ZOOMit)的小视野高清扩散加权成像(DWI)在直肠癌检测中的应用价值。方法前瞻性收集经内镜活检确诊为单发直肠癌的初诊病人77例[男53例,女24例,平均年龄(57.6±4.3)岁],均行ZOOMit-DWI和单次激发平面回波成像DWI(SS-EPI-DWI)检查,由2名医师进行影像主观评分及参数测量。采用Kappa检验和组内相关系数(ICC)分析2名医师主观评分及定量测量的一致性。采用Likert评分量表对影像抑脂、伪影和影像质量进行定性评分。测量2种DWI影像直肠癌病灶信号强度,计算病灶的信噪比(SNR)和对比噪声比(CNR)。比较2种DWI影像在同一层面上与T2WI上病灶影像的重叠率。2种影像的定性和定量资料比较采用配对样本t检验或Mann-Whitney U检验。结果2名医师的影像主观评分及定量参数测量的一致性均较好(P<0.05)。ZOOMit-DWI影像的抑脂、伪影、影像质量主观评分均高于SS-EPI-DWI(P<0.05)。ZOOMit-DWI影像的病灶信号强度、SNR以及CNR均高于SS-EPI-DWI[分别为305.45±57.15和208.85±46.33,83.98(69.20,112.68)和54.86(45.10,66.20),39.76(29.38,54.27)和27.34(18.22,36.53);均P<0.05]。ZOOMit-DWI影像的病灶影像重叠率中位数为75.59%(60.51%,88.17%),高于SS-EPI-DWI影像[63.35%(49.40%,73.24%)](P<0.05)。结论ZOOMit-DWI具有较好的影像质量,是一种很有前景的直肠肿瘤成像技术。Objective To explore the value of high-resolution small field-of-view diffusion-weighted imaging(DWI)based on zoomed imaging technique with parallel transmission(ZOOMit)in the detection of rectal cancer.Methods A total of 77 newly diagnosed patients with single rectal cancer confirmed by endoscopic biopsy(53 males,24 females,mean age 57.6±4.3 years)were prospectively enrolled.Each patient underwent both ZOOMit-DWI and single-shot echo-planner imaging DWI(SS-EPI-DWI)at same imaging session.Subjective scores and quantitative parameters were measured by two radiologists.Kappa test and intra-class correlation coefficient(ICC)were used to analyze the consistency of subjective scores and quantitative measurements by the two radiologists.A Likert-type scale was used to qualitatively score image fat suppression,artifact,and image quality.DWI signal intensity of rectal cancer lesions was measured in ZOOMit-DWI and SSEPI-DWI images,and the signal-noise ratio(SNR),and contrast to noise ratio(CNR)of the lesions were calculated.The overlap rate of lesion images on T2WI and DWI at the same level was compared.Qualitative and quantitative data from the two types of DWI images were compared using paired sample t test or Mann-Whitney U test.Results Both the subjective scores and parameter measurements by the 2 radiologists were consistent(P<0.05).The subjective scores for fat suppression,artifact,and image quality of ZOOMit-DWI images were higher than those of SS-EPI-DWI images(P<0.05).The lesion signal intensity,SNR,and CNR of ZOOMit-DWI images and SS-EPI-DWI images were 305.45±57.15 vs 208.85±46.33,83.98(69.20,112.68)vs 54.86(45.10,66.20),and 39.76(29.38,54.27)vs 27.34(18.22,36.53),respectively,with all the differences being statistically significant(P<0.05).The median overlap rate of ZOOMit-DWI images and SS-EPI-DWI images were 75.59%(60.51%,88.17%)and 63.35%(49.40%,73.24%),respectively,and the difference was statistically significant(P<0.05).Conclusion ZOOMit-DWI offers better image quality,making it a promising technology

关 键 词：直肠癌 磁共振成像 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]