磁共振IVIM-DWI及DCE-MRI在直肠癌诊断中的应用价值

Values of Magnetic Resonance IVIM-DWI and DCE-MRI in Diagnosis of Rectal Cancer

目的探讨磁共振(MRI)体素内不相干运动-扩散加权成像(IVIM-DWI)、动态增强MRI(DCE-MRI)在直肠癌诊断中的应用价值。方法选择2014年4月—2016年4月收治的56例直肠癌作为观察组,选择同期50例直肠正常者作为对照组,2组均接受MRI常规序列、IVIM-DWI及DCE-MRI检查,观察各组IVIM-DWI参数及TIC参数,分析IVIM-DWI、DCE-MRI及其联合诊断直肠癌T分期的准确率。结果与对照组比较,观察组真实扩散系统、灌注分数、表现扩张系数均降低,最大信号强度、强化至峰值时信号强度、早期增强率均升高(P<0.05);IVIM-DWI对直肠癌T分期诊断总准确率为75.00%,DCE-MRI为80.36%,联合诊断为87.50%。结论 IVIM-DWI、DCE-MRI对直肠癌及其T分期诊断具有一定的价值,二者联合检测能有效提高直肠癌T分期诊断准确率。

Objective To investigate values of magnetic resonance imaging （MRI） intravoxel incoherent motion imaging-diffuse weighing imaging （IVIM-DWI） and dynamic contrast-enhanced MRI （DCE-MRI） in diagnosis of rectal cancer. Methods A total of 56 patients with rectal cancer admitted during April 2014 and April 2016 were selected as observation group, and other 50 patients with normal rectum at the same period were selected as control group. All patients received MRI conventional sequences, IVIM-DWI and DCE-MRI examinations. In two groups, IVIM-DWI parameters and TIC parameters were compared, and accuracy rates of IVIM-DWI, DCE-MRI and their combination application in diagnosis of T stage of rectal cancer were compared. Results Compared with those in control group, the values of real diffusion coefficient, perfusion score and apparent diffusion coefficient were significantly decreased, while values of maxi- mum signal intensity, signal intensity at the time of strengthened to peak and early enhancement rate were significantly in- creased in observation group （P 〈 0. 05 ） ; accuracy rates of IVIM-DWI, DCE-MRI and their combination application in diagnosis of T stage of rectal cancer were 75.00% , 80.36% and 87.50% respectively. Conclusion Both IVIM-DWI and DCE-MRI have a certain value in diagnosis of T stage of rectal cancer, and combined detection can effectively improve the accuracy in diagnosis of T stage of rectal cancer.