本文選題：直腸腫瘤 + 磁共振成像�。� 參考：《放射學(xué)實踐》2017年09期

【摘要】：目的:探討高分辨力DWI-RESOLVE序列在直腸癌術(shù)前T分期中的價值。方法:回顧性分析經(jīng)術(shù)后病理證實的40例直腸腺癌患者的病例資料,按照病灶是否突破固有肌層分為未突破組(A組)和突破組(B組),A組包括T1期和T2期,共17例,B組包括T3期和T4期,共23例。全部患者均行RESOLVE序列掃描(b值=0、1000s/mm~2)。兩位醫(yī)師獨立分析圖像并測量感興趣區(qū)的ADC值;采用組內(nèi)相關(guān)系數(shù)(ICC)分析兩位醫(yī)師測量結(jié)果的一致性。根據(jù)病理結(jié)果描繪受試者工作特性(ROC)曲線,計算曲線下面積、最佳診斷閾值、敏感度和特異度。結(jié)果:A組的平均ADC值為(1.230±0.160)×10~(-3) mm~2/s(醫(yī)師1)和(1.200±0.166)×10~(-3) mm~2/s(醫(yī)師2),高于B組的平均ADC值[(0.973±0.216)×10~(-3) mm~2/s(醫(yī)師1)和(0.948±0.181)×10~(-3) mm~2/s(醫(yī)師2)],兩組間的ADC值差異有統(tǒng)計學(xué)意義(醫(yī)師1:t=4.129,P0.001;醫(yī)師2:t=4.503,P0.001)。兩位醫(yī)師ADC值測量結(jié)果的ICC為0.947。醫(yī)師1的曲線下面積為0.820(95%CI:0.666~0.923),敏感度為60.87%,特異度為94.12%,診斷閾值為0.98×10~(-3) mm~2/s;醫(yī)師2的曲線下面積為0.855(95%CI:0.708~0.946),敏感度為78.26%,特異度為76.47%,診斷閾值為1.07×10~(-3) mm~2/s。結(jié)論:高分辨力DWI-RESOLVE序列對于術(shù)前判斷直腸癌是否突破固有肌層(T2期和T3期的鑒別)具有較高的參考價值。
[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 鹵0.160 脳 10 ~ (-3) mm / s (doctor 1) and 1.200 鹵0.166 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) / s respectively, which were higher than those of group B [0.973 鹵0.216) 脳 10 ~ (-3) mm / s (doctor 1) and 0.948 鹵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.
【作者單位】： 上海第二軍醫(yī)大學(xué)附屬長海醫(yī)院影像醫(yī)學(xué)科;
【分類號】：R445.2;R735.37

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