3.0T磁共振扩散加权成像在直肠腺瘤评估中的应用价值

Application Value of 3.0T MR Diffusion Weighted Imaging in Assessment of Rectal Adenoma

目的探讨表观扩散系数(apparent diffusion coefficient,ADC)术前无创评估直肠腺瘤瘤体是否癌变的可行性。方法回顾性分析71例已经过手术病理证实的直肠病变患者(直肠腺瘤患者21例、直肠腺瘤并癌变患者14例及直肠腺癌患者36例)的MRI平扫及DWI检查,ADC值由b值为0 s/mm^(2)和1000s/mm^(2)的DWI检查计算所得,测量肿瘤的平均ADC值及最小ADC值,根据直肠腺瘤、直肠腺瘤癌变及直肠腺癌进行分组,采用独立样本t检验分别比较分析。结果直肠腺瘤及腺瘤癌变分组的最小ADC值(1.126±0.134比1.015±0.107,P=0.015)、直肠腺瘤及腺癌分组的平均A D C值(1.277±0.099比1.026±0.096,P=0.000)及最小A D C值(1.126±0.134比0.995±0.087,P=0.000)、直肠腺瘤癌变及腺癌分组的平均ADC值(1.207±0.116比1.026±0.096,P=0.000)及最小ADC值(1.015±0.107比0.995±0.087,P=0.047)具有统计学学意义,仅直肠腺瘤及腺瘤癌变分组的平均ADC值(1.277±0.099比1.207±0.116,P=0.064)无统计学意义,最小ADC值在评估直肠腺瘤瘤体是否癌变中的作用优于平均ADC值。结论ADC值可在一定程度上对直肠腺瘤是否癌变做出较好预测。

Objective To assess the value of apparent diffusion coefficient(ADC)in predicting rectal adenoma with or not canceration before surgery.Methods The MRI and DWI findings of 71 patients(21 rectal adenoma,14 rectal adenoma canceration and 36 rectal adenocarcinoma)had pathological proved were retrospectively analyzed.DWI with b=0 s/mm2 and b=1000s/mm2 were acquired.Average tumor ADCs and minimum tumor ADCs were measured and compared between subgroups stratified by rectal adenoma,rectal adenoma canceration and rectal adenocarcinoma,independent sample t test was used to compare them.Results It showed that the differences of minimum tumor ADCs(1.126±0.134,1.015±0.107,P=0.015)between rectal adenoma group and rectal adenoma canceration group,average tumor ADCs(1.277±0.099,1.026±0.096,P=0.000)and minimum tumor ADCs(1.126±0.134,0.995±0.087,P=0.000)between rectal adenoma group and rectal adenocarcinoma group,average tumor ADCs(1.207±0.116,1.026±0.096,P=0.000)and minimum tumor ADCs(1.015±0.107,0.995±0.087,P=0.047)between rectal adenoma canceration group and rectal adenocarcinoma group.There was no significant difference of average tumor ADCs(1.277±0.099,1.207±0.116,P=0.064)between rectal adenoma group and rectal adenoma canceration group,minimum tumor ADCs was better than average tumor ADCs when it was used to predict rectal adenoma with or not canceration.Conclusion ADC values can effectively predict rectal adenoma with or not canceration.