高分辨磁共振联合小FOV弥散加权成像在直肠癌分期中的应用价值

Value of high-resolution magnetic resonance combined with reduced FOV diffusion-weighted imaging in staging of rectal cancer

目的探讨高分辨磁共振联合小视野(FOV)弥散加权成像(DWI)在直肠癌分期中的应用价值。方法 79例直肠癌患者,均接受高分辨磁共振T2WI序列与DWI扫描,比较DWI、T2WI、DWI联合T2WI对直肠癌分期的诊断准确率。结果 79例患者术后病理检查结果显示,直肠癌T分期为:18例患者为T1期, 27例患者为T2期, 21例患者为T3期, 13例患者为T4期;直肠癌N分期为:37例患者为N0期, 26例患者为N1期, 16例患者为N2期。DWI诊断直肠癌T1分期的准确率为33.33%, T2分期的准确率为74.07%, T3分期的准确率为90.48%, T4分期的准确率为84.62%,总诊断准确率为70.89%。T2WI诊断直肠癌T1分期的准确率为72.22%, T2分期的准确率为81.48%, T3分期的准确率为95.24%, T4分期的准确率为92.31%,总诊断准确率为84.81%。DWI联合T2WI诊断直肠癌T1分期的准确率为94.44%, T2分期的准确率为96.30%, T3分期的准确率为100.00%, T4分期的准确率为100.00%,总诊断准确率为97.47%。DWI联合T2WI诊断直肠癌T分期的总准确率均高于DWI、T2WI,且T2WI总诊断准确率高于DWI,差异均具有统计学意义(P<0.05)。DWI联合T2WI诊断直肠癌N0分期的准确率为89.19%, N1分期的准确率为61.54%, N2分期的准确率为68.75%,总诊断准确率为75.95%。结论高分辨磁共振联合小FOV DWI可对直肠癌分期进行有效诊断,可为临床治疗方案制定提供参考。

Objective To discuss the application value of high-resolution magnetic resonance combined with reduced field of view(FOV) diffusion-weighted imaging(DWI) in staging of rectal cancer. Methods A total of 79 rectal cancer patients received high-resolution magnetic resonance T2WI sequence and DWI scan. The diagnostic accuracy of DWI, T2WI, DWI combined with T2WI in staging rectal cancer was compared. Results Postoperative pathological examination results of 79 patients showed T stage of rectal cancer: 18 patients were in stage T1, 27 patients were in stage T2, 21 patients were in stage T3, and 13 patients were in stage T4;N stage of rectal cancer: 37 patients were in N0 stage, 26 patients were in N1 stage, 16 patients were in N2 stage. The accuracy of DWI for rectal cancer T1 stage was 33.33%, T2 stage accuracy was 74.07%, T3 stage accuracy was 90.48%, T4 stage accuracy was 84.62%, and the overall diagnostic accuracy was 70.89%. The accuracy of T2WI for rectal cancer T1 stage was 72.22%, T2 stage accuracy was 81.48%, T3 stage accuracy was 95.24%, T4 stage accuracy was 92.31%, and the overall diagnostic accuracy was 84.81%. The accuracy of DWI combined T2WI for rectal cancer T1 stage was 94.44%, T2 stage accuracy was 96.30%, T3 stage accuracy was 100.00%, T4 stage accuracy was 100.00%, and the overall diagnostic accuracy was 97.47%. The total accuracy of DWI combined T2WI for rectal cancer T stage was higher than that of DWI and T2WI, and the total accuracy of T2WI was higher than that of DWI. Their difference was statistically significant(P<0.05). The accuracy of DWI combined T2WI for rectal cancer N0 stage was 89.19%, N1 stage accuracy was 61.54%, N2 stage accuracy was 68.75%, and the overall diagnostic accuracy was 75.95%. Conclusion High resolution magnetic resonance combined with reduced FOV DWI can effectively diagnose the stage of rectal cancer and provide reference for clinical treatment.