摘要
目的探讨高分辨率MRI扩散加权成像(DWI)对直肠癌患者术前T、N分期与环周切缘的判断价值。方法对收治的直肠癌127例患者行MRI与DWI检查,根据术后病理结果,分析MRI与DWI对直肠癌术前T分期与N分期的诊断价值以及对环周切缘的判断价值。结果MRI诊断T1期敏感度92.00%、特异度99.02%;T2期敏感度92.31%、特异度97.03%、T3期92.68%、特异度98.84%;T4期敏感度91.43%、特异度100.0%。MRI对N0期诊断敏感度93.02%、特异度94.05%、N1期敏感度89.13%、特异度97.53%、N2期敏感度93.33%、特异度100.0%。经单因素方差分析显示,不同分期患者b=800 mm^2/s基线下ADC值,差异具有统计学意义(P<0.05);其中T1、T2、T3期ADC值显著高于T4期,T1期显著高于T2、T3期,差异具有统计学意义(P<0.05)。b=800 mm^2/s基线下ADC值对T1期直肠癌患者的AUC为0.834、对T2期0.651、T3期0.546、T4期0.837。经单因素方差分析显示不同N分期患者ADC值,差异具有统计学意义(P<0.05)。结论MRI诊断直肠癌患者术前T、N分期具有较高价值,而DWI检查中b值基线下ADC在一定程度上可反映肿瘤细胞分化程度。
Objective To analyze the value of high-resolution nuclear magnetic resonance(MRI)and diffusion-weighted imaging(DWI)in the preoperative T,N staging and circumcision margin of rectal cancer patients,and to provide help for the diagnosis and treatment of the disease in clinical.Methods A retrospective analysis was made of 127 patients with rectal cancer admitted to our hospital from December 2018 to December 2019.All patients were examined by MRI and DWI.According to the postoperative pathological results,the diagnostic value of MRI and DWI in preoperative T and N stages of rectal cancer and the value in the judgment of circumcision margin were analyzed.Results The sensitivity and specificity of MRI were 92.00%and 99.02%in T1 phase,92.31%and 97.03%in T2 phase,92.68%and 98.84%in T3 phase,91.43%and 100.0%in T4 phase.The sensitivity,specificity,sensitivity and specificity of MRI were 93.02%,94.05%,89.13%,97.53%,93.33%and 100%respectively.The results of one-way ANOVA showed that there was a significant difference(P<0.05)between the ADC values at baseline of B=800 mm^2/s in patients of different stages(P<0.05);the ADC values at T1,T2 and T3 were significantly higher than those at T4,and those at T1 were significantly higher than those at T2 and T3(P<0.05).The AUC of B=800 mm^2/s was 0.834,0.651,0.546 and 0.837 for T1,T2,T3 and T4.The results of one-way ANOVA showed that the difference of ADC in different N stages was statistically significant(P<0.05),and the difference in N0 stage was significantly higher than that in N1 and N2 stage(P<0.05).Conclusion MRI has a high value in the diagnosis of preoperative T and N stages of rectal cancer,while ADC can reflect the degree of tumor cell differentiation to a certain extent under the b-value baseline in DWI.
作者
谷梅兰
肖新广
吕培培
GU Meilan;XIAO Xinguang;LYU Peipei(Department of Radiology, Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou 450000, P.R.China)
出处
《医学影像学杂志》
2021年第1期72-77,共6页
Journal of Medical Imaging
关键词
直肠癌
磁共振成像
Rectal cancer
Magnetic resonance imaging
