磁共振rFOV IVIM-DWI技术用于鉴别直肠癌分期的价值分析  

Value analysis of magnetic resonance rFOV IVIEM-DWI technique in differentiating stage of rectal cancer

作　　者：李晓维 张伯英 程秋波 轩翠华 Li Xiaowei;Zhang Boying;Cheng Qiubo;Xuan Cuihua(The 989th Hospital of the Joint Support Force,Henan Luoyang,471000)

机构地区：[1]联勤保障部队第九八九医院,河南洛阳471000

出　　处：《辽宁医学杂志》2024年第5期84-88,共5页Medical Journal of Liaoning

摘　　要：目的 分析磁共振小视野体素不相干运动扩散加权成像(rFOV IVIM-DWI)技术用于鉴别直肠癌分期的临床应用价值。方法 选取2022年1月至2023年1月于我院接受治疗的100例直肠癌患者为研究对象,均接受常规视野体素不相干运动扩散加权成像(fFOV IVIM-DWI)及rFOV IVIM-DWI检查。比较2位医师对IVIM-DWI图像的病灶变形及病灶清晰程度的主观评价结果、两组磁共振rFOV IVIM-DWI参数[表观弥散系数(ADC)、真实扩散系数(D)、假扩散系数(D^(*))、灌注分数(f)],通过ROC分析rFOV IVIM-DWI参数诊断直肠癌处于Ⅲ期、Ⅳ期的价值,将病理活检结果作为“金标准”,采用一致性分析rFOV IVIM-DWI参数诊断直肠癌处于Ⅲ期、Ⅳ期的价值。结果 2位医师均认为rFOV IVIM-DWI序列的图像变形程度低于fFOV IVIM-DWI序列相比,但DWI及ADC清晰度高于fFOV IVIM-DWI序列(P<0.05);Ⅲ期、Ⅳ期组ADC、D、f均低于Ⅰ期、Ⅱ期组(P<0.05),两组D^(*)比较无统计学意义(P>0.05);经ROC分析证实rFOV IVIM-DWI参数诊断能用于诊断直肠癌处于Ⅲ期、Ⅳ期,曲线下面积分别为0.921、0.907、0.913,且P<0.05;以ADC≤0.895×10^(-3)mm^(2)/s、D≤0.868×10^(-3)mm^(2)/s以及f≤25.59定义为直肠癌处于Ⅲ期、Ⅳ期。经一致性分析证实,rFOV IVIM-DWI技术诊断直肠癌处于Ⅲ期、Ⅳ期的准确率94.00%、灵敏度94.37%、特异度93.10%、阳性预测值97.10%、阴性预测值84.38%、Kappa值=0.857。结论 磁共振rFOV IVIM-DWI技术的图像质量较高,可明显提高常规视野下的图像清晰度,减少变形,且rFOV IVIM-DWI参数用于鉴别直肠癌分期的价值较高,将磁共振rFOV IVIM-DWI技术用于直肠癌诊断处于Ⅲ期、Ⅳ期,可进一步提高诊断结果的敏感度以及准确率,减少漏诊、误诊情况的发生,为临床诊治提供可靠依据,具有较高推广价值。Objective To analyze the image quality and clinical application value of magnetic resonance small field voxel-incoherence motion diffusion weighted imaging(rFOV IVIM-DWI)in the diagnosis of rectal cancer.Methods A to-tal of 100 patients with rectal cancer who received treatment in our hospital from January 2022 to January 2023 were select-ed as the study objects,and all of them underwent routine field voxel-indiscrete motion diffusion-weighted imaging(fFOV IVIM-DWI)and rFOV IVIM-DWI.Compare the subjective evaluation results of lesion deformation and lesion clarity of IVI-em-DWI images by two physicians,and the parameters of the two groups of magnetic resonance rFOV Iviem-DWI[apparent diffusion coefficient(ADC),true diffusion coefficient(D),false diffusion coefficient(D*),perfusion fraction(f)].ROC was used to analyze the value of rFOV IVlim-DWI parameters in the diagnosis of rectal cancer in stage Ⅱ and stage Ⅳ.Pathological biopsy results were taken as the"gold standard"and consistency was used to analyze the value of rFOV IVlim-DWI parameters in the diagnosis of rectal cancer in stage Ⅱ and stage Ⅳ.Results Both doctors believed that the degree of image deformation of rFOV IVlim-DWI sequence was lower than that of fFOV Ivim-DWI sequence,but the clarity of DWI and ADC was higher than that of fFOV Ivim-DWI sequence(P<0.05).ADC,D and f in stage Ⅱ and stage Ⅳ were lower than those in stage Ⅰ and stage Ⅱ groups(P<0.05),and there was no statistical significance in D*between two groups(P>0.05).ROC analysis proved that rFOV IVIM-DWI parameters could be used to diagnose rectal cancer in stage Ⅲ and stage Ⅳ.The areas under the curve were 0.921,0.907 and 0.913,respectively,and P<0.05.ADC≤0.895×10^(-3)mm^(2)/s,D≤0.868×10^(-3)mm^(2)/s,and f≤25.59 were defined as colorectal cancer in stage Ⅲ and stage IV.Consistency analysis confirmed that the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value were 94.00%,94.37%,93.10%,97.10%,84.38%,and 0.857 in th

关 键 词：磁共振成像 小视野 体素不相干运动扩散加权成像 直肠癌 图像质量 

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]