扩散加权成像在结肠癌诊断中的应用

Diffusion-Weighted Imaging in the Diagnosis of Colon Cancer

目的：比较MRI扩散加权成像（diffusion-weighted imaging,DWI）与常规平扫及增强序列在结肠癌诊断中的应用价值。材料与方法：收集30例结肠癌患者,其中男19例,女11例,年龄42~76岁,平均54岁。全部病例诊断均经手术病理证实。全部病例肠道清洁后进行MRI常规平扫及增强扫描、扩散加权成像（b值800s/mm2）检查,比较各序列图像对结肠癌病变、侵犯范围、转移灶等显示情况。结果：30例结肠癌中,T1WI病灶呈中等信号为26例,T2WI病灶呈等或稍高信号为23例,增强后24例病灶有明显强化;8例周围脂肪间隙侵犯,淋巴结转移3例,肝脏转移3例。DWI上30例病灶均呈高信号。DWI显示病灶率最高,高于T1WI、T2WI及增强T1WI。结论：肠道清洁后常规MRI序列结合DWI序列提高结肠癌病变显示率,清晰显示结肠癌病变详情及毗邻关系,对结肠癌的诊断、分期和可切除性评估等方面具有较高的临床应用价值。

Purpose： To compare the MRI diffusion-weighted imaging with conventional plain and enhanced the value of the sequence in diagnosis of colon cancer. Materials and Methods： 30 cases of colon cancer patients were sampled which including 19 males and 11 females,aged 42 to 76 years,mean 54 years. All cases were confirmed by pathology diagnosis. All patients performed after bowel cleansing routine plain and enhanced MRI scan,diffusion-weighted imaging（ b value 800 s /mm2） check,compare the sequence of images of the colon lesions,extent of involvement,metastases and other display cases.Results： 30 cases of colon cancer,T1 WI lesions were 26 cases of moderate signal,T2 WI lesions showed equal or slightly higher signal for the 23 cases,24 cases of lesions after enhanced significantly strengthened; fat space around eight cases of invasion,lymph node metastasis in 3 cases,three cases of liver metastasis. DWI lesions on the 30 cases showed high signal.DWI showed lesions highest rate higher than T1 WI,T2WI and enhanced T1 WI. Conclusion： After bowel cleansing routine MRI sequences combine DWI sequence display rate increase colon disease,colon cancer lesions clearly show details and adjacent relationship,for colon cancer diagnosis,staging and resectability assessment,and so has a high clinical value.