磁共振DWI、DCE-MRI联合检测在直肠癌分期诊断中的应用

doi:10.3760/cma.j.issn.1007-1245.2023.04.026

摘要/Abstract

摘要：

目的　观察磁共振弥散加权成像（DWI）、动态增强磁共振成像（DCE-MRI）联合检测直肠癌分期的应用价值。方法　回顾性分析烟台市烟台山医院影像科2020年8月至2021年8月收治的150例直肠癌患者资料，其中男83例，女67例，年龄31～68（49.35±9.64）岁，均行DWI及DCE-MRI检查，以术前病理学检查结果作为金标准，t检验比较直肠癌分化程度与检测参数ADC值及K^trans值的关系，χ²检验DWI检测、DCE-MRI检测及联合检测对肿瘤T分期的诊断价值。结果　150例患者病理学结果显示，黏液腺癌患者16例，ADC均值为（1.179±0.173）mm²/s，黏膜性腺癌患者134例，ADC均值为（0.896±0.141）mm²/s，黏液腺癌组ADC值显著高于黏膜性腺癌组（t=4.328，P<0.05）；黏膜性腺癌组ADC值随分化程度的升高而升高，K^trans值随分化程度的升高而降低，且组间比较差异均有统计学意义（F=47.548、51.125，均P<0.05）；术前DWI检测T₁、T₂、T₃、T₄期的准确率分别为83.33%（10/12）、86.36%（38/44）、94.67%（71/75）、89.47%（17/19），总准确率为90.67%（136/150）；DCE诊断T₁、T₂、T₃、T₄期的准确率分别为78.57%（11/14）、88.64%（39/44）、95.95%（71/74）、94.44%（17/18），总准确率为92.00%（138/150）；DWI结合DCE诊断T₁、T₂、T₃、T₄期的准确率分别为92.31%（12/13）、93.02%（40/43）、97.30%（72/74）、90.00%（18/20），总准确率为94.67%（142/150）。结论　DWI结合DCE-MRI检查有助于提高直肠癌分期诊断的准确性，值得推广。

关键词:

共振弥散加权成像, 磁共振动态增强扫描成像, 直肠癌, 分化程度, 分期诊断

Abstract:

Objective　To observe the value of diffusion-weighted magnetic resonance imaging (DWI) combined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis and staging of rectal cancer. Methods　The data of 150 patients with rectal cancer admitted to Department of Imaging, Yantaishan Hospital between August 2020 and August 2021 were retrospectively analyzed; among them, there were 83 males and 67 females; they were (49.35±9.64) years old. All the patients underwent DWI and DCE-MRI. The preoperative pathological examination results were used as the gold standard. t test was used to compare the relationship between the degree of differentiation of rectal cancer and the values of ADC and K^trans; χ² test was used to analyze the values of DWI, DCE-MRI, and combined detection in the diagnosis of tumor T stage. Results　Among the 150 patients, there were 16 cases of mucinous adenocarcinoma and 134 cases of mucosal adenocarcinoma. The ADC value of the mucinous adenocarcinoma group was significantly higher than that of the mucosal adenocarcinoma group [(1.179±0.173) mm²/s vs. (0.896±0.141) mm²/s; t=4.328, P<0.05]. The ADC value in the mucosal adenocarcinoma group increased with the differentiation degree; the K^trans value decreased as the differentiation degree increased (P<0.05). The accuracy rates of preoperative DWI in T₁-T₄ stages were 83.33% (10/12), 86.36% (38/44), 94.67% (71/75), and 89.47% (17/19), with a total accuracy rate of 90.67% (136/150). The accuracy rates of DCE in the diagnosis of T₁-T₄ stages were 78.57% (11/14), 88.64% (39/44), 95.95% (71/74), and 94.44% (17/18), with a total accuracy rate of 92.00% (138/150). The accuracy rates of DWI combined with DCE in diagnosing T₁-T₄ stages were 92.31% (12/13), 93.02% (40/43), 97.30% (72/74), and 90.00% (18/20), with a total accuracy rate of 94.67% (142/150). Conclusion　DWI combined with DCE-MRI can improve the accuracy of the staging and diagnosis of rectal cancer, so it is worthy of promotion.

Key words:

Diffusion-weighted magnetic resonance imaging, Dynamic contrast-enhanced magnetic resonance imaging, Rectal cancer, , Differentiation degree, Staging and diagnosis

林国栋.

磁共振DWI、DCE-MRI联合检测在直肠癌分期诊断中的应用 [J]. 国际医药卫生导报, 2023, 29(4): 554-558.

Lin Guodong.

Magnetic resonance imaging DWI combined with DCE-MRI in diagnosis and staging of rectal cancer [J]. International Medicine and Health Guidance News, 2023, 29(4): 554-558.

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