磁共振扩散加权成像在回盲部腺癌检查中的应用价值

The value of diffusion-weighted magnetic resonance imaging in the diagnosis of ileocecal adenocarcinoma

目的探讨磁共振扩散加权成像(DWI)在回盲部腺癌MRI检查中的应用价值。方法回顾分析我院收治的32例回盲部腺癌患者的磁共振资料,分析常规序列与DWI对病灶及淋巴结的显示情况,并与手术及病理资料对照。结果本组T2WI病灶呈稍高或高信号为30例,2例合并肠套叠无法区分病灶与套头;增强后30例病灶明显强化,2例病灶轻度强化;6例周围脂肪间隙侵犯;DWI上32例病灶均呈高信号。术后病理示病灶分期≤T2期13例、T3期13例、T4期6例;T2WI显示病灶T分期≤T2期8例、T3期16例、T4期6例(2例合并肠套叠无法显示),准确率83.3%(25/30);T2WI联合DWI显示病灶T分期≤T2期12例、T3期14例、T4期6例,准确率96.8%(31/32);手术病理示淋巴结转移14例。常规磁共振序列检查有12例转移性淋巴结,敏感度85.7%;磁共振扩散加权成像检查出16例转移性淋巴结,敏感度100%。结论扩散加权成像结合常规序列有助于提高回盲部腺癌的诊断准确性,对淋巴结的检查敏感性更高,可有效降低漏诊率。

Objective To evaluate the value of diffusion-weighted magnetic resonance imaging(DWI)in the diagnosis of ileocecal adenocarcinoma.Methods The MRI data of 32 patients with ileocecal adenocarcinoma were analyzed retrospectively. The conventional sequence and DWI were used to display the lesions and lymph nodes,and the results were compared with the surgical and pathological data.Results In this study,32 cases of ileocecal adenocarcinoma were confirmed by operation and pathology,30 cases of T2 WI lesions were slightly high or high signal intensity,2 cases with intussusception could not distinguish the focus from the socket,30 cases showed obvious enhancement after enhancement,2 cases showed slight enhancement. Peripheral fat space invasion was found in 6 cases and hyperintense in 32 cases on DWI.Pathological findings showed that 13 cases had stage ≤T2,13 cases had stage T3,6 cases had stage T4. T2 WI showed T stage ≤T2 in 8 cases,T3 in 16 cases,T4 in 6 cases(2 cases with intussusception failure).The accuracy rate was 83.3%(25/30).T2 WI combined with DWI showed T stage ≤T2 in 12 cases,T3 in 14 cases and T4 in 6 cases.The accuracy rate was 96.8%(31/32).14/32 cases of ileocecal adenocarcinoma showed lymph node metastasis.12 cases of metastatic lymph nodes were examined by conventional MRI sequence,The sensitivity was 85.70%.16 cases of metastatic lymph nodes were examined by DWI,the sensitivity was 100%.Conclusion Diffusion weighted imaging combined with conventional sequence can improve the accuracy of diagnosis of ileocecal adenocarcinoma and is more sensitive to lymph node examination. It can effectively reduce the rate of missed diagnosis.