T_(2)mapping技术在鉴别直肠黏液腺癌和非黏液腺癌中的价值

Value of T_(2)mapping technique in distinguishing rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma

目的:探讨T_(2)mapping技术对直肠黏液腺癌和非黏液腺癌的鉴别诊断价值。方法:前瞻性纳入直肠癌患者69例,其中黏液腺癌9例,非黏液腺癌60例,所有患者均行盆腔MRI检查,扫描序列包括T_(2)mapping及DWI序列。由2位经验丰富的放射科医师独立测量病灶的T_(2)值及ADC值,采用独立样本t检验或Mann-Whitney U检验比较不同病理类型肿瘤各参数值的差异。采用ROC曲线和DeLong检验分析T_(2)值、ADC值及两者联合的诊断效能。结果:直肠黏液腺癌的T_(2)值及ADC值均高于非黏液腺癌,差异均有统计学意义(均P<0.05)。T_(2)值、ADC值及联合指标(T_(2)值+ADC值)鉴别直肠黏液腺癌和非黏液腺癌的AUC分别为0.96、0.81和0.97,T_(2)值与ADC值的差异及联合指标与ADC值的差异均有统计学意义(均P<0.05)。结论:T_(2)mapping对直肠黏液腺癌与非黏液腺癌的鉴别诊断效能优于DWI,DWI联合T_(2)mapping可显著提高对直肠黏液腺癌与非黏液腺癌的鉴别诊断准确率。

Objective:To investigate the value of T_(2)mapping in distinguishing rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma.Methods:Sixty-nine patients with rectal cancer(9 patients with mucinous adenocarcinoma,60 patients with non-mucinous adenocarcinoma)underwent pelvic MRI T_(2)mapping and DWI.T_(2)and ADC values of lesions were measured independently by two experienced radiologists,and the differences between mucinous and non-mucinous adenocarcinoma were compared using independent sample t test or Mann-Whitney U test.The ROC curve and DeLong test were used to test the diagnostic efficiency of T_(2)and ADC values.Results:T_(2)and ADC values of rectal mucinous adenocarcinoma were higher than those of non-mucous adenocarcinoma(both P<0.05).AUCs of T_(2)value,ADC value and the combined indicators(T_(2)+ADC)in distinguishing rectal mucinous adenocarcinoma and non-mucinous adenocarcinoma were 0.96,0.81 and 0.97,respectively,and the AUC of T_(2)value and the combined indicators were statistically different with that of ADC value(both P<0.05).Conclusions:T_(2)mapping has a higher diagnostic efficiency in differentiating rectal mucinous and non-mucinous adenocarcinoma than DWI.And DWI combined with T_(2)mapping can significantly improve the diagnostic accuracy.