磁共振不同序列对直肠癌环周切缘诊断价值

Diagnostic value of different sequences of MRI in rectal cancer

目的探讨与对比磁共振(Magnetic resonance imaging,MRI)不同序列对直肠癌环周切缘(circumferential resection margin,CRM)的诊断价值。方法选择2016年8月-2020年3月选择在兵团第二师焉耆医院诊治的直肠癌患者72例作为研究对象,所有患者都均行MRI诊断,所选择序列分别为T1WI、T2WI、DWI,判断诊断特征与诊断效果。结果在72例患者中,病理诊断为CRM阳性22例(阳性组),占比30.6%。阳性组病灶呈现稍长T1WI与T2WI信号,不规则环形强化,水肿带明显,占位效应明显,边界模糊。当b值=0s/mm^(2)、1000s/mm^(2)时,阳性组的ADC值均显著低于阴性组(P <0.05)。T1WI、T2WI、DWI诊断为CRM阳性分别为20例、21例与22例,诊断敏感性为86.4%、90.9%和100.0%,诊断特异性为98.0%、98.0%和100.0%;T1WI、T2WI、DWI诊断CRM的一致性Kappa值为0.91,表明一致性极好。结论 MRI T1WI、T2WI、DWI序列诊断直肠癌CRM都有很高的敏感性与特异性,有助于指导在临床上选择合理的治疗方案。

Objective To investigate the diagnostic values of different sequences of magnetic resonance imaging(MRI) for the circumferential resection margin(CRM)of rectal cancer. Methods From August 2016 to March 2020, 72 cases with rectal cancer who were diagnosed and treated in the Second Division yanqi Hospital were selected as the research object, all patients were given MRI diagnosis, and the selected sequences were T1WI, T2WI, and DWI, respectively, and the diagnosis characteristics and diagnosis effects were judged. Results There were 22 cases were pathologically diagnosed as CRM positive(positive group)that accounted for 30.6%.The lesions in the positive group showed slightly longer T1WI and T2WI signals, irregular ring enhancement, obvious edema zone, obvious space-occupying effect, and blurred boundaries. When the b value= 0 s/mm^(2), 1000 s/mm^(2), the ADC value of the positive group were significantly lower than that of the negative group(P < 0.05). T1WI, T2WI, and DWI were diagnosed as CRM positive in 20 cases, 21 cases, and 22 cases, respectively, with diagnostic sensitivities of 86.4%, 90.9%, and 100.0%, and diagnostic specificities of 98.0%, 98.0%,and 100.0%;T1WI, T2WI, The consistency Kappa value of DWI diagnosis CRM were 0.91, indicated that the consistency are excellent.Conclusions MRI T1WI, T2WI, and DWI sequences have high sensitivity and specificity for the diagnosis of rectal cancer CRM, which was helpful for guiding the clinical selection of reasonable treatment options.