發(fā)布時(shí)間：2018-06-08 13:10

  本文選題：直腸癌 + 磁共振成像��； 參考：《臨床放射學(xué)雜志》2017年06期

【摘要】：目的探討直腸癌磁共振擴(kuò)散加權(quán)成像(DWI)表觀擴(kuò)散系數(shù)(ADC)值與腫瘤病理分級(jí)的相關(guān)性。方法回顧性分析經(jīng)手術(shù)病理證實(shí)為直腸癌的患者115例。所有患者術(shù)前均行盆腔MRI平掃、增強(qiáng)及DWI檢查。根據(jù)磁共振平掃及增強(qiáng)圖像明確腫瘤的部位及范圍,觀察病灶DWI(b=800 s/mm~2)信號(hào),測(cè)量腫瘤實(shí)性部分的平均ADC值、最小ADC值。比較病理分級(jí)不同組間腫瘤實(shí)性部分平均ADC值、最小ADC值與病理分級(jí)的相關(guān)性。運(yùn)用受試者工作特征(ROC)曲線分析兩者診斷高、低分化直腸癌的最佳臨界值及其效能。結(jié)果低、中、高分化直腸癌腫瘤實(shí)性部分平均ADC值分別為(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;低分化組平均ADC值低于中、高分化組(P0.05),平均ADC值與病理分級(jí)無(wú)相關(guān)性(r_s=-0.09,P0.05);最小ADC值分別為(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,低分化組最小ADC值均低于中、高分化組(P0.05)。最小ADC值與病理分級(jí)呈負(fù)相關(guān)(r_s=-0.301,P0.05),以≥1.052×10~(-3)mm~2/s為閾值,最小ADC值診斷高分化直腸癌的敏感度為83.3%,特異度為57%,ROC曲線下面積(AUC)為0.685;以≤0.967×10~(-3)mm~2/s為閾值,最小ADC值診斷低分化直腸癌的敏感度為67.7%,特異度為81.8%,ROC曲線AUC為0.747。結(jié)論直腸癌DWI腫瘤最小ADC值有助于術(shù)前預(yù)判腫瘤病理分級(jí)。
[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 鹵1.206) 脳 10 ~ (-3) ~ (-1) / 2 ~ (-1 / 2) / s ~ (-1. 135 鹵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 鹵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 鹵0.103) 脳 10 ~ (-3) mm ~ (-2) / s ~ (1. 021 鹵0.169) 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1. 120 鹵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，

本文編號(hào)：1995901