磁共振全身弥散成像对结直肠癌原发病灶筛查的价值

Detection of colorectal carcinoma with MR whole-body diffusion-weighted imaging

目的:探讨磁共振全身弥散成像(WB-DWI)对结直肠癌原发病灶筛查方面的价值。方法:对已经确诊的结直肠癌患者43例作为研究组,另随机选取健康人群10例,痔疮患者8例,息肉患者10例作为对照组,进行常规MRI及WB-DWI检查,进行常规MRI、WB-DWI、手术、病理资料对比研究分析。结果:结直肠癌在WB-DWI上表现为较高信号,与正常肠管相比,其DWI信号强度明显高于正常肠壁的信号强度(P<0.05),其ADC值明显小于正常肠壁的ADC值(P<0.05)。WB-DWI最终正确诊断68例,3例假阳性诊断,0例假阴性诊断。WB-DWI对结直肠癌原发病灶检出的敏感性为100%(43/43),特异性为89%(25/28),诊断准确性为96%(68/71)。结论:WB-DWI可以快速发现结直肠癌,对结直肠癌的全身筛查和早期诊断方面具有重要意义。

Objective:To explore the value of MR whole-body diffusion-weighted imaging(WB-DWI) in detecting the primary colorectal carcinoma.Methods:Forty-three patients with primary colorectal carcinoma and ten healthy men,eight patients with hemorrhoids(3 with internal hemorrhoids,3 external hemorrhoids,and 2 mixed hemorrhoids),10 patients with polyp were enrolled in this study.The patients were studied with conventional MRI and WB-DWI and compared with conventional MRI,WB-DWI,surgery with pathology.Results:The primary colorectal carcinoma appeared high signal on WB-DWI,its signal density was higher than normal bowel(P<0.05) on DWI,its ADC value was markedly lower than normal bowel(P<0.05).All of patients with colorectal carcinoma were diagnosed correctly by WB-DWI and the sensitivity,specificity and accuracy of WB-DWI was 100%(43/43),89%(25/28) and 96%(68/71) respectively.Conclusion:WB-DWI examination could detect primary colorectal carcinoma quickly,which had an important value in general screening and detecting early primary colorectal carcinoma.