磁共振高分辨率DWI-RESOLVE序列扫描在老年直肠癌患者术前T分期中的诊断效能研究

Diagnostic Efficacy of High Resolution DWI-resolve sequence scan in Preoperative T Staging of Rectal Cancer in Elderly Patients

目的探讨磁共振高分辨率DWI-RESOLVE序列在老年直肠癌术前T分期诊断中的诊断效能。方法选取2019年1月-2020年1月在上海长海医院接受住院治疗的80例老年直肠癌患者为研究对象。所有患者均接受MRI检查,并分别采用常规DWI序列及高分辨率DWI-RESOLVE序列扫描,比较不同DWI序列检测的定量参数、不同DWI序列成像质量以及采用高分辨率DWI-RESOLVE序列检测的敏感度、特异度。结果与常规DWI比较,DWI-RESOLVE序列的SNR及CNR均较高(P<0.05),而两者的CR及ADC值则无显著差异(P>0.05);与常规DWI比较,DWIRESOLVE序列的成像质量均较高(P<0.05);经ROC曲线分析显示,常规DWI扫描的敏感度为0.723%、特异度为0.711%、诊断阈值1.32×10^-3mm^2/s,低于DWI-RESOLVE序列扫描的敏感度(86.7%)、特异度(68.4%)和诊断阈值(1.13×10^-3mm^2/s)(P<0.05)。结论对直肠癌患者采用高分辨率DWI-RESOLVE序列扫描,对判定直肠癌是否突破固有肌层具有较好的效果,其诊断的敏感度及特异度较高,成像质量较高;测定ADC值有助于反映机体组织结构的功能信息,可将其作为术前评估的有效方法。

Objective To explore the diagnostic efficacy of MRI high-resolution DWI-resolve sequence scan in preoperative T staging of rectal cancer in elderly patients.Methods 80 elderly patients with rectal cancer who were hospitalized in Shanghai Changhai Hospital fromJanuary 2019 to January 2020 were selected as the research subjects.All patients underwent MRI examination,and were scanned with conventional DWI sequence and high-resolution DWI-resolve sequence.The quantitative parameters,the imaging quality,and the diagnostic sensitivity and specificity of different DWI sequences scan were compared.Results Compared with conventional DWI sequence scan,the SNR and CNR of high-resolution DWI-resolve sequence scan were higher(P<0.05),but there was no significant difference in Cr and ADC between the two DWI sequences scans(P>0.05).Compared with conventional DWI sequence scan,high-resolution DWI-resolve sequence scan had higher imaging quality(P<0.05).The ROCcurve analysis showed that the sensitivity of conventional DWI sequence scan was 0.723%,the specificity was 0.711%,and the diagnostic threshold was 1.32×10^-3mm^2/s,which was lower than the sensitivity(86.7%),specificity(68.4%)and diagnostic threshold(1.13×10^-3mm^2/s)of high-resolution DWI-resolve sequence scan(P<0.05),respectively.Conclusion The high-resolution DWI-resolve sequence scan for patients with rectal cancer has a good effect on judging whether rectal cancer breaks through the muscularis propria.The sensitivity,specificity and imaging quality of the diagnosis are high.The measurement of ADC value is helpful to reflect the functional information of tissue structure,and can be used as an effective method for preoperative evaluation.