磁共振T2WI联合DWI对评估原发性直肠癌病情严重程度的应用分析  

Application Analysis of Magnetic Resonance T2-Weighted Imaging Combined with Diffusion-Weighted Imaging in Assessing the Severity of Primary Rectal Cancer

作　　者：王苗 WANG Miao(Department of Imaging,Second People's Hospital of Luohe,Luohe Henan 462000,China)

机构地区：[1]漯河市第二人民医院影像科,河南漯河462000

出　　处：《临床研究》2025年第4期151-154,共4页Clinical Research

摘　　要：目的研究磁共振T_(2)加权成像技术(T2WI)与扩散加权成像技术(DWI)结合在评价原发性直肠癌病情严重度方面的实际应用价值。方法选取2019年1月至2024年6月期间在漯河市第二人民医院接受治疗并经病理学检查确认的80例直肠癌患者病例资料进行回顾性研究。以病理学检查结果作为金标准,分别对DWI、T2WI以及两者联合使用在直肠癌T_(1)、T_(2)、T_(3)、T_(4)分期诊断中的敏感度、特异度及一致性进行评估。结果根据病理切片检查的结论,参与本研究的患者中,T_(1)期患者11例,T_(2)期患者25例,T_(3)期患者31例,T_(4)期患者13例。利用DWI序列对直肠癌各分期进行诊断时,敏感度分别为63.64%、68.00%、64.52%、61.54%,特异度分别为92.75%、83.64%、79.59%、94.03%。而采用T2WI序列进行诊断时,敏感度分别为72.73%、60.00%、58.06%、61.54%,特异度分别为92.75%、87.27%、79.59%、86.57%。当DWI与T2WI联合应用时,对于各分期患者的诊断敏感度分别提升至90.91%、96.00%、93.55%、92.31%,诊断特异度分别提升至100.00%、96.36%、95.92%、98.51%。以病理学诊断为金标准,DWI单独诊断的Kappa系数为0.506,T2WI为0.463,联合使用时Kappa系数高达0.911。三种诊断方式针对T_(2)、T_(3)、T_(4)期患者的诊断敏感度比较,差异有统计学意义(P<0.05),针对T_(3)、T_(4)期患者的诊断特异度比较,差异有统计学意义(P<0.05)。结论DWI结合高分辨率T2WI序列对于直肠癌分期诊断效能较优,与病理结果间具有良好的诊断一致性,值得临床应用。Objective To study the practical application value of combining T_(2)-weighted imaging(T2WI)with diffusionweighted imaging(DWI)in evaluating the severity of primary rectal cancer.Methods A retrospective study was conducted using the clinical data of 80 rectal cancer patients who were treated at the Second People's Hospital of Luohe and confirmed by pathological examination from January 2019 to June 2024.Using pathological examination results as the gold standard,the sensitivity,specificity,and consistency of DWI,T2WI,and their combined use in diagnosing the stages T_(1),T_(2),T_(3),and T_(4) of rectal cancer were evaluated.Results According to the conclusions from pathological sections,among the patients involved in this study,there were 11 cases of T_(1) stage,25 cases of T_(2) stage,31 cases of T_(3) stage,and 13 cases of T_(4) stage.When diagnosing rectal cancer stages using DWI sequences,the sensitivities were 63.64%,68.00%,64.52%,and 61.54%,with specificities of 92.75%,83.64%,79.59%,and 94.03%,respectively.In contrast,when using T2WI sequences for diagnosis,the sensitivities were 72.73%,60.00%,58.06%,and 61.54%,with specificities of 92.75%,87.27%,79.59%,and 86.57%,respectively.When DWI and T2WI were used together,the sensitivity for each stage increased to 90.91%,96.00%,93.55%,and 92.31%,while the specificity improved to 100.00%,96.36%,95.92%,and 98.51%,respectively.Using pathological diagnosis as the gold standard,the Kappa coefficient for DWI alone was 0.506,for T2WI was 0.463,and the joint use had a Kappa coefficient as high as 0.911.The comparison of diagnostic sensitivity among the three diagnostic methods for T_(2),T_(3),and T_(4) stage patients showed statistically significant differences(P<0.05),while comparisons of diagnostic specificity for T_(3) and T_(4) stage patients also showed statistically significant differences(P<0.05).Conclusion The combination of DWI with high-resolution T2WI sequences offers superior efficacy in staging rectal cancer and demonstrates good diagnostic consistency with pat

关 键 词：磁共振 直肠癌 敏感度 特异度 诊断效能 T2WI DWI 

分 类 号：R735.3[医药卫生—肿瘤]