3.0T MRI联合DWI及MSCT对直肠癌分期及分化程度的诊断价值

Diagnostic value of 3.0T MRI combined with DWI and MSCT in staging and differentiation of rectal cancer

目的 探究3.0T磁共振成像(MRI)联合弥散加权成像(DWI)及多层螺旋CT(MSCT)对直肠癌分期及分化程度的诊断价值。方法 回顾性分析2018年2月至2021年11月宝鸡市人民医院收治的82例直肠癌患者的临床资料,所有患者均在术前完成3.0T MRI、DWI和MSCT检查,以术后病理学结果为“金标准”,分析3.0T MRI联合DWI及MSCT在诊断直肠癌T、N分期的正确率,比较不同分化程度直肠癌患者的表观扩散系数(ADC)值和指数化表观扩散系数(eADC)值。结果 MRI联合DWI、MSCT诊断T分期直肠癌的总正确率为97.56%,明显高于MRI+MSCT、DWI+MSCT和MRI+DWI联合检查(分别为75.61%、81.71%、67.07%),差异均有统计学意义(P<0.05);MRI联合DWI、MSCT诊断N分期直肠癌的总正确率为100.00%,明显高于MRI+MSCT、DWI+MSCT和MRI+DWI联合检查(分别为71.95%、80.49%、85.37%),差异均有统计学意义(P<0.05);ADC值和e ADC值随着直肠癌分化程度的增加而提高,即高分化直肠癌患者的ADC值和eADC值明显高于中分化和低分化患者,中分化患者的ADC值和e ADC值明显高于低分化,差异均有统计学意义(P<0.05)。结论 3.0T MRI联合DWI及MSCT能够在术前较为准确地对直肠癌患者的T、N分期进行评价,ADC值和e ADC值与直肠癌的分化程度有关。

Objective To research the diagnostic value of 3.0T magnetic resonance imaging(MRI) combined with diffusion weighted imaging(DWI) and multi-slice spiral CT(MSCT) in staging and differentiation of rectal cancer.Methods The medical records of 82 patients with rectal cancer treated in Baoji People’s Hospital from February 2018to November 2021 were retrospectively analyzed. All patients underwent 3.0T MRI, DWI, and MSCT before operation.The accuracy of 3.0T MRI combined with DWI and MSCT in the diagnosis of T and N stages of rectal cancer was analyzed, and the apparent diffusion coefficient(ADC) value and exponential apparent diffusion coefficient(e ADC) value of patients with rectal cancer of different differentiation degrees were compared, taking postoperative pathological results as the "gold standard". Results The accuracy rate of MRI combined with DWI and MSCT in the diagnosis of T-stage rectal cancer was 97.56%, which was significantly higher than 75.61% of MRI+MSCT, 81.71% of DWI+MSCT, and 67.07% of MRI+DWI(P<0.05). The diagnostic accuracy of MRI combined with DWI and MSCT in the diagnosis of N-stage rectal cancer was 100.00%, which was significantly higher than 71.95% of MRI+MSCT, 80.49% of DWI+MSCT, and 85.37%of MRI+DWI(P<0.05). ADC value and e ADC value increased with the increase of differentiation degree of rectal cancer,that is, the ADC value and e ADC value of well-differentiated rectal cancer patients were significantly higher than those of moderately differentiated and poorly differentiated patients, and the ADC value and e ADC value of moderately differentiated patients were significantly higher than those of poorly differentiated patients, with statistically significant differences(P<0.05). Conclusion 3.0T MRI combined with DWI and MSCT can accurately evaluate the T and N stages of rectal cancer before operation. ADC value and EADC value are related to the degree of differentiation of rectal cancer.