磁共振扩散加权成像在直肠肿瘤性病变诊断中的价值

The value of diffusion weighted magnetic resonance imaging in the diagnosis of rectal tumors

目的通过对不同类型直肠肿瘤病例DWI图像分析和ADC值的测量探讨扩散加权成像对直肠肿瘤性病变的诊断价值。方法比较8例直肠腺瘤,30例中分化腺癌,6例低分化腺癌,7例黏液腺癌,6例淋巴瘤及5例间质瘤的ADC值的差异。结果 1直肠淋巴瘤的ADC值明显低于直肠癌、直肠腺瘤,差异有统计学意义(P<0.05),淋巴瘤与间质瘤之间差异无统计学意义(P>0.05);2直肠腺瘤ADC值低于粘液腺癌(P<0.05),与间质瘤、腺癌之间差异无统计学意义(P>0.05);3间质瘤ADC值低于粘液腺癌(P<0.05),与淋巴瘤、腺癌、腺瘤之间差异无统计学意义(P>0.05);4粘液腺癌ADC值高于中分化腺癌(P<0.05),与低分化腺癌之间差异无统计学意义(P>0.05),中分化、低分化腺癌之间差异无统计学意义(P>0.05)。结论扩散加权成像对不同类型直肠肿瘤、不同类别的直肠腺癌具有一定的鉴别诊断价值,联合MR常规扫描可提高诊断效能。

Objective To investigate the value of diffusion weighted MRI and apparent diffusion coefficient （ADC） in the diagnosis of rectal tumors .Methods We compared the ADC values of 8 cases of rectal adenoma ,30 cases of adenocarcino‐ma ,6 cases of low differentiated adenocarcinoma ,7 cases of mucinous carcinoma ,6 cases of lymphoma and 5 cases stromal tumor .Results ① The ADC values of rectal lymphoma were significantly lower than those of rectal cancer and rectal ade‐noma （ P〈0 .05） .There was no statistically significant difference between lymphoma and stromal tumor （ P〉0 .05）;②The ADC value of rectal adenoma was lower than those of mucinous adenocarcinoma and higher than that of lymphoma （ P〈0 .05） .There was no significant difference between stromal tumor and adenocarcinoma （ P〉0 .05）;③ The ADC value of stromal tumor was lower than that of mucinous adenocarcinoma （ P〈0 .05） .There were no differences among lympho‐ma ,adenocarcinoma and adenoma （ P〉0 .05）;④ The ADC value of mucinous adenocarcinoma was higher than that of the moderately differentiated adenocarcinoma （ P〈0 .05） .There was no significant difference between mucinous adenocarci‐noma and poorly differentiated adenocarcinoma ,moderately differentiated adenocarcinoma and poorly differentiated adeno‐carcinoma （ P 〉0 .05） .Conclusion Diffusion weighted imaging has certain values in differential diagnosis for different types of rectal tumor and some different types of rectal carcinoma .Combined with routine MR scanning can improve the diagnosis efficiency .