高分辨力DWI-RESOLVE序列在直肠癌术前T分期中的价值

发布时间：2018-06-10 11:05

本文选题：直肠肿瘤 + 磁共振成像　；参考：《放射学实践》2017年09期

【摘要】：目的:探讨高分辨力DWI-RESOLVE序列在直肠癌术前T分期中的价值。方法:回顾性分析经术后病理证实的40例直肠腺癌患者的病例资料,按照病灶是否突破固有肌层分为未突破组(A组)和突破组(B组),A组包括T1期和T2期,共17例,B组包括T3期和T4期,共23例。全部患者均行RESOLVE序列扫描(b值=0、1000s/mm~2)。两位医师独立分析图像并测量感兴趣区的ADC值;采用组内相关系数(ICC)分析两位医师测量结果的一致性。根据病理结果描绘受试者工作特性(ROC)曲线,计算曲线下面积、最佳诊断阈值、敏感度和特异度。结果:A组的平均ADC值为(1.230±0.160)×10~(-3) mm~2/s(医师1)和(1.200±0.166)×10~(-3) mm~2/s(医师2),高于B组的平均ADC值[(0.973±0.216)×10~(-3) mm~2/s(医师1)和(0.948±0.181)×10~(-3) mm~2/s(医师2)],两组间的ADC值差异有统计学意义(医师1:t=4.129,P0.001;医师2:t=4.503,P0.001)。两位医师ADC值测量结果的ICC为0.947。医师1的曲线下面积为0.820(95%CI:0.666~0.923),敏感度为60.87%,特异度为94.12%,诊断阈值为0.98×10~(-3) mm~2/s;医师2的曲线下面积为0.855(95%CI:0.708~0.946),敏感度为78.26%,特异度为76.47%,诊断阈值为1.07×10~(-3) mm~2/s。结论:高分辨力DWI-RESOLVE序列对于术前判断直肠癌是否突破固有肌层(T2期和T3期的鉴别)具有较高的参考价值。
[Abstract]:Objective: to evaluate the value of high resolution DWI-RESOLVE sequence in preoperative T staging of rectal cancer. Methods: the data of 40 patients with rectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed. According to whether the lesions broke through the lamina propria, they were divided into two groups: group A (without breakthrough) and group A (group B), including T1 and T2 stages. A total of 17 cases (23 cases) in group B included T 3 and T 4. All patients were examined by RESOLVE sequence. The two physicians independently analyzed the images and measured the ADC values of the region of interest, and analyzed the consistency of the results of the two physicians by using the intra-group correlation coefficient (ICCC). The area under the curve, the best diagnostic threshold, the sensitivity and the specificity were calculated according to the pathological results. Results the average ADC values of group A were 1.230 卤0.160 脳 10 ~ (-3) mm / s (doctor 1) and 1.200 卤0.166 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) / s respectively, which were higher than those of group B [0.973 卤0.216) 脳 10 ~ (-3) mm / s (doctor 1) and 0.948 卤0.181 脳 10 ~ (-3) mm / s (2) respectively. The ICC of ADC value measured by two doctors was 0. 947. The area under the curve of physician 1 was 0.820 / 95, the sensitivity was 60.87, the specificity was 94.12, the diagnostic threshold was 0.98 脳 10 ~ (-3) mm / s, and the area under the curve of physician 2 was 0.855 ~ (95) CIW 0.7080.9466.The sensitivity was 78.266.The specificity was 76.477.The diagnostic threshold was 1.07 脳 10 ~ (-3) mm / s. Conclusion: high resolution DWI-RESOLVE sequence has a high reference value in the diagnosis of rectal cancer before operation.
【作者单位】：上海第二军医大学附属长海医院影像医学科;
【分类号】：R445.2;R735.37

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