表观弥散系数值在直肠癌术前分期中的应用

发布时间：2018-01-05 03:22

本文关键词：表观弥散系数值在直肠癌术前分期中的应用　出处：《中国医学计算机成像杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的:探讨磁共振弥散加权成像(DWI)的定量指标表观弥散系数(ADC)在直肠癌术前分期中的应用价值。方法:回顾性分析经手术病理证实的直肠腺癌患者34例(突破固有肌层19例为B组,未突破15例为A组),均于术前约一周内行磁共振检查,扫描序列包括T2WI和DWI(b=0,1000s/mm2)。两名医生分析图像,统计分析T2WI区分两组病灶的特异度、敏感度、阴性预测值及阳性预测值。DWI图像上测量并分析两组病灶ADC值是否具有差异,通过ROC分析得出最佳诊断阈值及敏感度和特异度。计算组内相关系数衡量两名医生的测量一致性。采用ROC方法比较ADC与T2WI在病灶是否突破固有肌层诊断方面的差异。结果:T2WI图像上诊断为未突破6例,突破28例,特异度、敏感度、阴性预测值及阳性预测值为40%、100%、100%、67.7%。A组ADC值(1.102±0.173)×10-3mm2/s明显高于B组的(0.880±0.008)×10-3mm2/s(t=4.588,P0.05),ROC曲线分析获得最佳诊断阈值为0.923×10-3mm2/s,曲线下面积为0.902,敏感度及特异度为84.2%,86.7%。采用配对ROC方法比较ADC值与T2WI区分两组的准确性具有统计学意义(Z=2.025,P0.05)。结论:与常规T2WI相比,ADC值的应用可提高判断术前直肠癌病灶是否突破固有肌层的特异度。
[Abstract]:Objective: To explore the diffusion weighted magnetic resonance imaging (DWI) quantitative index of apparent diffusion coefficient (ADC) application value in staging of rectal cancer. Methods: a retrospective analysis of 34 patients with pathologically confirmed rectal adenocarcinoma patients (through the muscularis propria in 19 cases of B group, 15 cases of A without breaking group), were preoperatively about within one week of magnetic resonance imaging, scanning sequences included T2WI and DWI (b=01000s/mm2). The two doctor image analysis, statistical analysis of T2WI distinguish between the two groups of lesions of specificity, sensitivity, negative predictive value and positive predictive value of.DWI image measurement and analysis of two groups were ADC whether there is difference, through the ROC analysis of the best diagnostic threshold and the sensitivity and specificity of measurement. The consistency of two doctors measured the intraclass correlation coefficient was calculated by ROC method. The comparison of ADC and T2WI in the lesion muscle layer differences break through the inherent diagnosis. Results: the T2WI image The diagnosis for 6 cases of breakthrough, breakthrough in 28 cases, the specificity, sensitivity, negative predictive value and positive predictive value of 40%, 100%, 100%, 67.7%.A group ADC (1.102 + 0.173) * 10-3mm2/s was higher than that of B group (0.880 + 0.008) * 10-3mm2/s (t=4.588, P0.05), by ROC curve analysis the best diagnostic threshold is 0.923 * 10-3mm2/s, the area under the curve was 0.902, the sensitivity and specificity of 84.2%, 86.7%. by paired ROC method to compare the ADC value and T2WI distinguish the accuracy of the two group were statistically significant (Z=2.025, P0.05). Conclusion: compared with conventional T2WI, the application value of ADC can improve the preoperative judgment of rectal cancer the lesion is breakthrough muscularis propria specificity.

【作者单位】：上海交通大学医学院附属瑞金医院放射科;
【基金】：国家自然科学基金No.U1532107,81171312,81272746 上海市科委医学引导项目134119a5900 国家临床重点专科建设项目
【分类号】：R445.2;R735.37
【正文快照】： 结直肠癌是消化系统常见的恶性肿瘤之一,其中2.MRI检查方法直肠癌约占1/3。尤其在我国,其发病率及死亡率成本院采用西门子(Siemens Aera 1.5T),病上升趋势[1],手术切除仍是其主要治愈方式。进展期人于扫描前2小时用短柄开塞露两支清洁肠道,扫直肠癌患者(术前诊断病灶已突破固

【相似文献】