本文選題：直腸癌 + 體素內不一致運動序列��； 參考：《臨床放射學雜志》2015年12期

【摘要】：目的初步探討直腸癌體素內不一致運動磁共振成像(IVIM-MRI)序列的成像特點,進一步研究探討IVIM參數(shù)標準ADC、真實擴散系數(shù)(D)、灌注相關擴散系數(shù)(D*)、灌注分數(shù)(f)及表觀擴散系數(shù)(ADC)值對直腸癌術前病理分級的評估價值。方法分析30例經(jīng)手術病理證實為直腸癌患者的IVIM參數(shù)標準ADC、D、D*、f值及DWI資料,結合病理結果,分析在腫瘤不同分化程度、T分期及N分期中的區(qū)別。結果 D在直腸癌分化程度組、T分期組的差異有統(tǒng)計學意義(F值分別為3.700、12.846;P0.05),ADC值在直腸癌分化程度組、T分期組的差異有統(tǒng)計學意義(F值分別為3.823、7.881;P0.05),兩者在N分期組中差異均無統(tǒng)計學意義(F值分別為0.510、0.214;P0.05)。多重比較顯示腫瘤分化程度組的高-中分化組與中分化組[95%可信區(qū)間(*104):0.358~4.608,P=0.018]、中-低分化組[95%可信區(qū)間(*104):0.1578~4.819,P=0.033]的D值差異有統(tǒng)計學意義(P0.05),腫瘤分化程度組的高-中分化組與中分化組[95%可信區(qū)間(*104):4.968~52.34,P=0.013]、中-低分化組[95%可信區(qū)間(*104):1.73~53.689,P=0.033]的ADC值差異有統(tǒng)計學意義(P0.05);腫瘤T分期中T1期與其他三期之間的D值[95%可信區(qū)間(*104)分別為:1.167~5.135、1.868~5.872、2.358~6.362]差異有統(tǒng)計學意義(P0.05),腫瘤T分期中T1期與其他三期之間的ADC值[95%可信區(qū)間(*104)分別為:15.945~66.615、17.09~68.227、17.562~68.698]差異有統(tǒng)計學意義(P0.05),T2期與T4期之間的D值差異有統(tǒng)計學意義[95%可信區(qū)間(*104):0.032~2.386,P0.05]。各參數(shù)在N0期~N2期之間差異均無統(tǒng)計學意義(P0.05)。結論 D及ADC值可在一定程度上反映直腸癌的病理分級,并可以初步認為,相較于常規(guī)ADC值,D值可以更客觀準確地評估腫瘤的惡性程度。
[Abstract]:Objective to investigate the imaging characteristics of IVIM-MRI sequence of incoherent motion MRI in rectal cancer. To further study the value of IVIM parameter standard, real diffusion coefficient, perfusion correlation diffusion coefficient, perfusion fraction and apparent diffusion coefficient in preoperative pathological grading of rectal cancer. Methods the IVIM parameters and DWI data of 30 patients with rectal cancer proved by operation and pathology were analyzed. The difference between T stage and N stage of tumor with different differentiation degree was analyzed in combination with pathological results. Results the difference between D and T staging group was significant (F = 3.700 ~ 12.846 / P 0.05). There was significant difference between D and T staging group (3.8237.881 / P 0.05), respectively. The difference between the two groups in N stage group was lower than that in N stage group. The difference was significant in the T stage group of rectal cancer differentiation degree group (P < 0.05), and the difference between the two groups was significant (P < 0.05), and the difference between the two groups was significant (P < 0.05). There was no significant difference in F value between 0. 510 and 0. 214m P 0. 05, respectively. Multiple comparisons showed that there were significant differences in D values between high and medium differentiation group and medium differentiated group [95% confidence interval 1044% 0.358% 4.608% P0. 018] and middle to low differentiation group [95% confidence interval 104% 0.1578% 4.819% P0. 033]. There was significant difference in D value between high to middle differentiation group and high to middle differentiation group of tumor differentiation degree group (P 0. 05). The ADC value of middle differentiation group [95% confidence interval] [95% confidence interval] had statistical significance (P 0.05); the D value of T _ 1 stage and other three stages in T _ 1 stage were 1.1675.135 ~ 1.868 ~ 5.8722.3586.362 respectively] there was significant difference in ADC value between T _ 1 stage and other three stages. [95% confidence interval = 1.1675.135U 1.8685.8722.3586.362] there was a significant difference in ADC value between T _ 1 stage and other three stages in T _ 1 stage (95% confidence interval = 1.1675.135n = 1.8685.8722.3586.362). The ADC value of T 1 stage and the other three stages in T stage of tumor were: 1: 15.945 / 66.615 / 17.09 68.227 / 17.562 / 68.698 respectively. There was significant difference in D value between T _ 2 stage and T _ 4 stage [95% confidence interval (95% confidence interval) = 104w / 0.032: 2.386p0.05], and there was a significant difference between T _ 1 and T _ 4 stage in T _ 1 stage and T _ 4 stage [95% confidence interval (95% confidence interval) was 0.032: 2.386p0.05]. There was significant difference in D value between T _ 2 stage and T _ 4 stage in T _ 1 stage. There was no significant difference in the parameters between N 0 and N 2 stages (P 0.05). Conclusion D and ADC values can reflect the pathological grade of rectal cancer to a certain extent, and it can be preliminarily considered that compared with the conventional ADC value, D value can be used to evaluate the malignant degree of the tumor more objectively and accurately.
【作者單位】： 鄭州大學附屬腫瘤醫(yī)院河南省腫瘤醫(yī)院放射科;
【分類號】：R735.37;R445.2

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