直肠癌扩散加权成像ADC值与病理分级的相关性研究

发布时间：2018-06-08 13:10

  本文选题：直肠癌 + 磁共振成像　； 参考：《临床放射学杂志》2017年06期

【摘要】：目的探讨直肠癌磁共振扩散加权成像(DWI)表观扩散系数(ADC)值与肿瘤病理分级的相关性。方法回顾性分析经手术病理证实为直肠癌的患者115例。所有患者术前均行盆腔MRI平扫、增强及DWI检查。根据磁共振平扫及增强图像明确肿瘤的部位及范围,观察病灶DWI(b=800 s/mm~2)信号,测量肿瘤实性部分的平均ADC值、最小ADC值。比较病理分级不同组间肿瘤实性部分平均ADC值、最小ADC值与病理分级的相关性。运用受试者工作特征(ROC)曲线分析两者诊断高、低分化直肠癌的最佳临界值及其效能。结果低、中、高分化直肠癌肿瘤实性部分平均ADC值分别为(0.984±1.206)×10~(-3)mm~2/s、(1.135±1.423)×10~(-3)mm~2/s、(1.219±0.347)×10~(-3)mm~2/s;低分化组平均ADC值低于中、高分化组(P0.05),平均ADC值与病理分级无相关性(r_s=-0.09,P0.05);最小ADC值分别为(0.869±0.103)×10~(-3)mm~2/s、(1.021±0.169)×10~(-3)mm~2/s、(1.120±0.165)×10~(-3)mm~2/s,低分化组最小ADC值均低于中、高分化组(P0.05)。最小ADC值与病理分级呈负相关(r_s=-0.301,P0.05),以≥1.052×10~(-3)mm~2/s为阈值,最小ADC值诊断高分化直肠癌的敏感度为83.3%,特异度为57%,ROC曲线下面积(AUC)为0.685;以≤0.967×10~(-3)mm~2/s为阈值,最小ADC值诊断低分化直肠癌的敏感度为67.7%,特异度为81.8%,ROC曲线AUC为0.747。结论直肠癌DWI肿瘤最小ADC值有助于术前预判肿瘤病理分级。
[Abstract]:Objective to investigate the correlation between the apparent diffusion coefficient (ADCC) of diffusion weighted Mr imaging (DWI) and pathological grade of rectal cancer. Methods 115 cases of rectal cancer proved by operation and pathology were retrospectively analyzed. All patients underwent pelvic MRI plain scan, contrast enhancement and DWI before operation. According to Mr plain scan and enhancement images, the location and range of the tumor were determined, and the DWIb ~ (800 s / mm ~ (-2) signal was observed, and the mean ADC value and the minimum ADC value of the solid part of the tumor were measured. The correlation between the mean partial ADC value of solid tumor and the minimum ADC value and pathological grade were compared. The optimal critical value and its effectiveness in the diagnosis of high and low differentiated rectal cancer were analyzed by using the operating characteristics of the subjects. The results showed that the mean ADC values of low, middle and well-differentiated rectal cancer were 0.984 卤1.206) 脳 10 ~ (-3) ~ (-1) / 2 ~ (-1 / 2) / s ~ (-1. 135 卤1.423) 脳 10 ~ (-3) mm ~ (-2) / s, respectively, and the mean ADC value of low differentiation group was lower than that of middle group, and the mean ADC value was 1.219 卤0.34 ~ (7) 脳 10 ~ (-3) mm ~ (-2) / s, respectively. There was no correlation between the average ADC value and the pathological grade. The minimum ADC values were 0.869 卤0.103) 脳 10 ~ (-3) mm ~ (-2) / s ~ (1. 021 卤0.169) 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1. 120 卤0.165) 脳 10 ~ (-3) mm ~ 2 / s, respectively. The minimum ADC values of the low differentiation group were all lower than those of the high differentiation group. There was a negative correlation between the minimum ADC value and the pathological grade. With 鈮，

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