多b值DWI联合HR-T_(2)WI在直肠癌术前分期及环周切缘评估中的应用  

The application of multi b-value DWI combined with HR-T_(2)WI in preoperative staging and circumferential resection margin evaluation of rectal cancer

作　　者：郭新 陈芳 黄从坤 卞志伟 王康 周坤生 张超[2] GUO Xin;CHEN Fang;HUANG Congkun;BIAN Zhiwei;WANG Kang;ZHOU Kunsheng;ZHANG Chao(Anhui West Health Vocational College Affiliated Hospital(Second People's Hospital of Lu'an City)MRI Room,Lu'an 237000,China)

机构地区：[1]皖西卫生职业学院附属医院(六安市第二人民医院)磁共振室,安徽六安237000 [2]皖南医学院,安徽芜湖241002

出　　处：《医学影像学杂志》2024年第7期78-81,85,共5页Journal of Medical Imaging

基　　金：安徽省重点研究与开发计划项目(编号:201904a07020063)。

摘　　要：目的 探讨多b值扩散加权成像(DWI)联合高分辨率T2加权成像(HR-T2WI)在直肠癌术前分期及环周切缘(CRM)评估价值。方法 选取80例经病理确诊为直肠癌患者,术前均接受多b值DWI、HR-T2WI检查,比较不同T、N分期及CRM性质患者多b值下表观弥散系数(ADC)差异。以病理组织学检查为金标准,采用Kappa一致性检验多b值DWI联合HR-T2WI诊断结果与病理组织学诊断结果的一致性。结果 T1分期6例,T2分期20例,T3分期32例,T4分期22例;N0分期41例,N1分期23例,N2分期16例;CRM阴性49例,阳性31例。多b值下T1分期患者ADC高于T2、T3、T4分期,且T2分期高于T3、T4分期,T3分期高于T4分期,差异有统计学意义(P<0.05)。多b值下N0分期患者ADC高于N1、N2分期,N1分期高于N2分期,差异均有统计学意义(P<0.05);CRM阴性ADC高于阳性,差异有统计学意义(P<0.05)。HR-T2WI诊断4例T1分期,22例T2分期,31例T3分期,23例T4分期。HR-T2WI检出36例N0分期,28例N1分期,16例N2分期。经Kappa一致性检验显示,HR-T2WI诊断T分期、N分期、CRM性质结果与病理组织学结果存在较强一致性(Kappa=0.730、0.781、0.688,P<0.001)。多b值DWI联合HR-T2WI诊断5例T1分期,23例T2分期,31例T3分期,21例T4分期。多b值DWI联合HR-T2WI诊断39例N0分期,24例N1分期,17例N2分期。结论 多b值DWI联合HR-T2WI对直肠癌术前分期、CRM性质具有良好的诊断价值。Objective To explore the application value of multi b-value diffusion-weighted imaging(DWI)combined with high-resolution T2 weighted imaging(HR-T2WI)in preoperative staging and circumferential resection margin(CRM)evaluation of rectal cancer.Method Retrospective collection of clinical data was performed from 80 patients diagnosed with rectal cancer through histopathology,all of whom underwent preoperative multi b-value DWI and HR-T2WI examinations.The differences in apparent diffusion coefficient(ADC)among patients with different T,N stages,and CRM properties under multiple b-values were compared.Histopathological examination was used as the gold standard,Kappa consistency test was used to verify the con‐sistency between the multi b-value DWI combined with HR-T2WI diagnostic results and histopathological diagnostic results.Re-sults There were 6 cases in T1 phase,20 cases in T2 phase,32 cases in T3 phase,and 22 cases in T4 phase;41 cases in N0 phase,23 cases in N1 phase,and 16 cases in N2 phase;49 cases were negative for CRM and 31 cases were positive.Under mul‐tiple b values,the ADC of T1 patients was higher than that of T2,T3,and T4,and T2 was higher than T3 and T4.T3 was higher than T4,with statistical significant differences(P<0.05).Under multiple b values,the ADC of N0 patients was higher than N1 and N2,and N1 was higher than N2,with statistical significant differences(P<0.05).CRM negative ADC was higher than posi‐tive,with statistical significant differences(P<0.05).HR-T2WI diagnosed 4 cases with T1 staging,22 cases with T2 staging,31 cases with T3 staging,and 23 cases with T4 staging.HR-T2WI detected 36 cases of N0 staging,28 cases of N1 staging,and 16 cases of N2 staging.According to the Kappa consistency test,there was a strong consistency between the HR-T2WI diagnostic T stage,N stage,CRM nature results and pathological histological results(Kappa=0.730,0.781,0.688,P<0.001).Multiple b-value DWI combined with HR-T2WI was used to diagnose 5 cases of T1 staging,23 cases of T2 staging,31 cases of T3 sta

关 键 词：扩散加权成像 B值 高分辨率 直肠癌 环周切缘 

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