MR-DWI在直肠癌T分期及细胞分化评估中的应用价值  

Application Value of MR-DWI in T Staging and Cell Differentiation Evaluation of Rectal Cancer

作　　者：周雅芬 钱娟[1] Zhou Yafen;Qian Juan(Department of Radiology,Wuzhong Peoples Hospital,Suzhou,Jiangsu 215128)

机构地区：[1]苏州市吴中人民医院放射科,江苏苏州215128

出　　处：《现代医用影像学》2024年第11期2108-2112,共5页Modern Medical Imageology

摘　　要：目的:探讨磁共振(MR)—弥散加权成像(DWI)中表观弥散系数(ADC)值在直肠癌T分期及肿瘤细胞分化程度中的预测价值。方法:收集2018年2月至2022年12月住院经手术病理证实的直肠癌患者50例作为研究对象,分析所有患者的MRI常规序列及DWI图像,观察肿瘤的大小、浸润肠壁深度及范围,测量直肠病变区域ADC值,以手术病理结果按T分期分为A组(T1、T2)和B组(T3、T4),按肿瘤细胞分化程度分为C组(高中分化、中分化)和D组(中低分化、低分化)。比较ADC值在A组与B组、C组与D组间的差异,并做ROC曲线评估ADC值的预测能力。结果:A组患者的肿瘤ADC均值(1.01×10^(-3)mm^(2)/s)明显高于B组(0.88×^(-3)mm^(2)/s),具有统计学差异(P<0.001),以ADC=0.93×^(-3)mm^(2)/s为界值预测直肠癌T分期,产生ROC曲线下面积(AUC)0.826,敏感性75%,特异性72%;同样,C组患者的肿瘤ADC均值(1.03×^(-3)mm^(2)/s)明显高于D组(0.89×^(-3)mm^(2)/s),具有统计学差异(P<0.001),以ADC=0.98×^(-3)mm^(2)/s为界值预测直肠癌肿瘤细胞分化程度,产生AUC 0.864,敏感性78%,特异性83%。结论:MRI尤其是DWI的应用,其肿瘤ADC值在一定程度上能反映直肠癌的术前T分期、癌细胞分化程度,这为临床治疗方案的选择提供重要参考依据。[Abstract]Objective:To investigate the predictive value of ADC(apparent diffusion coefficient)in MR-DWI in T-staging and tumor cell differentiation of rectal cancer.Methods:Ffty patients with rectal cancer confirmed by surgery and pathology in our hospital from February 2018 to December 2022 were collected as the research objects.The conventional MRI sequences and DWI images of all patients were analyzed,and the tumor size,depth and range of intestinal wall infiltration were observed,and the ADC value of rectal lesion area was measured.According to the results of surgery and pathology,they were divided into group A(T1,T2)and group B(T3,T4)according to the degree of tumor cell differentiation,and group C(high school differentiation).Compare the differences of ADC values between group A and group B,group C and group D,and make ROC curve to evaluate the predictive ability of ADC values.Results:The average ADC of tumor in group A(1.01×^(-3)mm^(2)/s)was significantly higher than that in group B(0.88×^(-3)mm^(2)/s),with statistical diference(P<0.001).Taking ADC=0.93×^(-3)mm^(2)/s as the boundary value,the T-stage of rectal cancer was predicted,resulting in the area under ROC curve(AUC).Similarly,the average ADC of tumor in group C(1.03×^(-3)mm^(2)/s)was significantly higher than that in group D(0.89×^(-3)mm^(2)/s),with a statistical difference(P<0.001).Taking ADC=0.98×^(-3)mm^(2)/s as the boundary value,the differentiation degree of rectal cancer cells was predicted,resulting in AUC of O.88.Conclusion:The ADC value of MRI,especially DWI,can reflect the preoperative T stage of rectal cancer and the degree of cancer cell differentiation to some extent,which provides an important reference for the selection of clinical treatment schemes.

关 键 词：MRI 弥散加权成像 表观弥散系数 直肠癌 T分期 癌细胞分化 

分 类 号：R73[医药卫生—肿瘤]