作者：黄治华，罗丹丹，倪程

单位：恩施土家族苗族自治州中心医院 放射科，湖北 恩施 445000

Authors:  HUANG Zhihua, LUO Dandan, NI Cheng

Unit:  Department of Radiology, The Central Hospital Of Enshi Tujia And Miao Autonomous Prefecture, Enshi 445000, Hubei, China

摘要：

目的  探讨3.0T高分辨率磁共振(HR-MRI)平扫联合磁共振扩散加权成像(DWI)在直肠癌病情分期诊断中的价值。方法  回顾性分析我院自2017年2月-2018年2月间收治的65例直肠癌患者临床资料,以手术病理诊断结果为金标准,分析3.0T MRI平扫、平扫联合DWI在检测病灶部位、临床分期和环周切缘(CRM)状态评估中的价值。结果  直肠癌患者术前采用MRI平扫配合DWI可以准确的定位病灶位置和显示其形态;3.0T MRI平扫T分期诊断准确率为73.85%,与病理诊断结果一致性一般;MRI平扫+DWI诊断准确率为81.54%,与病理诊断结果一致性良好;联合诊断在直肠癌术前CRM状态评估准确度、敏感度、特异度以及一致性Youden指数均显著优于单纯MRI诊断,数据差异有统计学意义(P<0.05)。结论  3.0T高分辨率MRI平扫联合DWI诊断直肠癌准确性更高,与病理诊断结果的一致性良好,因此可以为手术方案确定提供指导和参考。

关键词： 3.0T磁共振; 平扫; 扩散加权成像; 直肠癌; 病理分期

Abstract：

Objective  To evaluate the value of 3.0T high resolution magnetic resonance (HR-MRI) plain scan combined with Mr diffusion weighted imaging (DWI)in staging of rectal cancer. Methods  Retrospective analysis of 65 cases of rectal cancer patients admitted from February 2017 to February 2018 in our hospital, with surgical pathological diagnosis as the gold standard, analysis of 3.0T MRI plain scan, plain scan combined with DWI in the detection of lesions , clinical stage and value of the circumferential margin (CRM)status assessment. Results  Patients with rectal cancer underwent MRI plain scan combined with DWI to accurately locate the lesion and display its morphology. The accuracy of 3.0T MRI plain T-stage diagnosis was 73.85%, which was consistent with pathological diagnosis. MRI plain scan+ The diagnostic accuracy of DWI was 81.54%, which was consistent with pathological diagnosis. The accuracy, sensitivity, specificity and consistency of Youden index in the diagnosis of preoperative CRM status in rectal cancer were significantly better than those in MRI. Statistical significance (P<0.05). Conclusion  3.0T high-resolution MRI plain scan combined with DWI for the diagnosis of rectal cancer is more accurate and consistent with the pathological diagnosis results, so it can provide guidance and reference for the surgical plan.

Key Words:  3.0T MRI; Plain scan; Diffusion weighted imaging; Rectal cancer; Pathological stage