非增强磁共振对无肠道准备结肠癌的诊断价值

The value of non-contrast MRI in diagnosing colon cancer with unprepared-bowel

目的探讨非增强磁共振序列组合(DWI联合T2WI)诊断无肠道准备结肠癌的价值。方法采用3.0T MRI对36例无肠道准备的结肠癌患者行全腹部扫描,两名影像医师独立分析所有受检者的常规MRI序列(T2WI),DWI联合T2WI序列及DCE-MRI序列的图像,评判各个序列诊断无肠道准备结肠癌的读者间一致性,并两两对比评估各序列的诊断准确性、敏感性、特异性、阳性预测值及阴性预测值。结果 DWI联合T2WI获得了很好的读者间一致性(κ0.85),常规MRI及DCE-MRI序列仅获得了较好的读者间一致性(κ0.64,κ0.74);对于诊断无肠道准备的结肠癌,DWI联合T2WI的各组参数值明显高于常规MRI及DCE-MRI序列(P<0.05),DCE-MRI的各组参数值高于常规MRI(P<0.05)。结论非增强磁共振序列组合(DWI联合T2WI)可以较准确有效地诊断无肠道准备的结肠癌。

Objective To evaluate the value of non-contrast MRI （combination of DWI and T2WI） to diagnose colon cancer with unprepared-bowel. Methods 36 colon caneer patients with unprepared-bowel underwent whole abdominal MRI scanning on a 3 T MR unit. Two radiologists independently evaluated images with three imaging sets： T2WI, combination of DWI and T2WI, DCE-MRI. The reader agreement for diagnosing unprepared-bowel colon cancer with the three imaging sets was analyzed, and the sensitivity, specificity, PPV （positive predictive value） and NPV （negative predictive value） were eompared among the three im- aging sets. Results Reader agreement was good for the eombination of DWI and T2WI （ κ0.85 ）, but was fair for T2WI and DCE-MRI （ κ0.64,κ 0.74）. For diagnosing colon cancer with unprepared-bowel, all the parameters of the combination of DWI and T2 WI were higher than those of T2 WI and DCE-MRI, and all the parameters for DCE-MRI were biger than those of T2 WI （ P 〈 0.05 ）. Conclusion Combination of non-contrast T2 WI and DWI at 3 T can provide accurate information for diagnosing colon cancer with unprepared-bowel.