榆林市126例结直肠癌MR-DWI与临床病理特征的相关性分析

Correlations between MR-DWI and Clinicopathological Characteristics of 126 Cases of Colorectal Cancer in Yulin

目的探讨榆林市126例结直肠癌MR-DWI影像学特征,分析其与临床病理特征的相关性。方法回顾性分析2012年1月-2018年3月在我院接受诊治的126例陕西榆林籍结直肠癌患者,统计分析所有患者MR-DWI影像学特征与术后病理特征,分析MR-DWI影像学特征与术后病理特征的一致性。结果 126例结直肠癌中,23例表现为肿瘤病灶低信号,形态不规则,而邻近黏膜及黏膜下层相对高信号,57例呈肌层低信号高信号交替环绕肿瘤病灶,且肌层低信号呈完整连续型环状,其中48例肿瘤病灶边缘毛糙或信号不均匀,9例DWI影像上淋巴结呈明显高信号。33例肿瘤信号透过肌层,肌层与肠周脂肪组织分界模糊不清;其中7例可见肠周脂肪组织高信号,多呈迂曲条索状或结节状,13例邻近组织器官出现肿瘤信号,或邻近组织器官间脂肪间隙模糊不清,其中3例DWI影像上淋巴结呈明显高信号。MRDWI影像学T分期与术后病理T分期Kappa=0.826,P<0.05;MR-DWI影像学N分期与术后病理N分期Kappa=0.626,P<0.05。经分析发现,MR-DWI的ADC值与病理检查结果中分化程度、是否累及筋膜、淋巴转移个数均存在显著相关性(P<0.05)。结论 126例结直肠癌患者MR-DWI影像分期与病理分期的一致性较好,且ADC值与病理检查结果存在显著相关性。

Objective To analyze the features of MR-DWI imaging in 126 cases of colorectal cancer and their correlations with clinicopathological characteristics.Methods The clinical data on 126 patients with colorectal cancer treated between January2012 and March 2018 was collected and retrospectively analyzed. The imaging features of MR-DWI and postoperative pathological features of all the patients were observed. The consistency between the imaging features of MR-DWI and the pathological features after operation was also analyzed.Results Among the 126 cases of colorectal cancer,23 cases showed a low signal intensity and irregular shape,and 57 cases of adjacent mucous membrane and submucous membrane had a relatively high signal intensity thatalternately surrounded the tumor lesion. The myometrium hypointensity became a complete continuous annular pattern. In 48 cases,the margin of tumor lesions was rough or the signal intensity was uneven. In 9 cases,the lymph nodes on DWI showed obvious hyperintensity. In 33 cases,tumor signal passed through the muscular layer,and the boundary between the muscular layer and peri-intestinal adipose tissue was blurred. 7 cases showed hyperintensity of peri-intestinal adipose tissue. In 13 cases,tumor signals appeared in adjacent tissues and organs,or fat gaps between adjacent tissues and organs were blurred. In 3 cases,the lymph nodes on DWI were significantly hyperintense.The result of consistence showed that the Kappa value of MR-DWI imaging T stage and postoperative pathological T stage was 0. 826（ P〈0.05）,while that of MR-DWI imaging N stage and postoperative pathological N stage was 0. 626（ P〈0.05）. It was found that the value of MR-DWI was significantly correlated with the degree of differentiation as shown by the results of pathological examination（ P〈0. 05）. Conclusion In the 126 patients with colorectal cancer,the MR-DWI imaging staging is consistent with the pathological staging,and the ADC value is significantly correlated with pathological findings.