高分辨率MR T2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解

发布时间：2018-04-08 12:44

本文选题：扩散磁共振成像　切入点：直肠肿瘤　出处：《中国介入影像与治疗学》2017年03期

【摘要】：目的探讨高分辨率MR T2WI联合DWI预测直肠癌新辅助治疗后病理学完全缓解的效能。方法回顾分析经完整新辅助治疗后接受根治性手术、新辅助治疗前后有完整2次MR影像资料、有明确病理学评价的进展期直肠癌患者364例,计算并比较单独使用高分辨率T2WI、高分辨率MR T2WI联合DWI预测直肠癌病理学完全缓解的效能。结果最终49例患者经病理证实为肿瘤完全缓解。单独使用高分辨率T2WI判断直肠癌是否病理学完全缓解的准确率为82.69%(301/364)、敏感度为40.82%(20/49)、特异度89.21%(281/315)、阳性预测值为37.04%(20/54)、阴性预测值为90.65%(281/310);高分辨率T2WI联合DWI预测直肠癌病理学完全缓解的准确率为87.36%(318/364)、敏感度为65.31%(32/49)、特异度为90.79%(286/315)、阳性预测值为52.46%(32/61)、阴性预测值为94.39%(286/303)。两种方法的敏感度差异有统计学意义(χ~2=4.96,P=0.03)。结论与单独使用高分辨率T2WI比较,高分辨率T2WI联合DWI评价直肠癌新辅助治疗后病理学完全缓解可提高诊断效能。
[Abstract]:Objective to evaluate the efficacy of high resolution Mr T2WI combined with DWI in predicting complete remission of rectal cancer after neoadjuvant therapy.Methods 364 patients with advanced rectal cancer who received radical surgery after complete neoadjuvant therapy were retrospectively analyzed.The effectiveness of high resolution T 2 WI, high resolution Mr T2WI combined with DWI in predicting complete remission of rectal cancer was calculated and compared.Results 49 patients were confirmed by pathology as complete remission.The accuracy of high resolution T2WI alone in judging complete remission of rectal cancer was 82.691.301 / 364g, sensitivity was 40.82% 20 / 49, specificity 89.21 / 281 / 315C, positive predictive value was 37.04% / 54%, negative predictive value was 90.65% / 31010g; High-resolution T2WI combined with DWI was used to predict complete pathology of rectal cancer.The accuracy of remission was 87.36 / 318 / 364, the sensitivity was 65.31 / 49, the specificity was 90.79 / 286 / 315, the positive predictive value was 52.46 / 32 / 61, and the negative predictive value was 94.39 / 286 / 3033.The sensitivity of the two methods was significantly different (蠂 ~ (2 / 2) 4.96 P ~ (0.03)).Conclusion compared with high resolution T2WI alone, high resolution T2WI combined with DWI can improve the diagnostic efficacy in evaluating the complete remission of rectal cancer after neoadjuvant therapy.
【作者单位】：北京大学肿瘤医院医学影像科北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室;
【基金】：国家自然科学基金青年项目(81501621)
【分类号】：R735.37

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