高分辨率MRI联合表观扩散系数值在直肠癌患者术前评估中的应用

Application of high-resolution MRI combined with apparent diffusion coefficient values in preoperative evaluation of rectal cancer patients

目的 探讨高分辨率MRI联合表观扩散系数(ADC)值在直肠癌患者术前评估中的应用效果。方法 选取98例拟行手术治疗的直肠癌患者,均接受高分辨率MRI、弥散加权成像(DWI)检查,记录ADC值;于检查完成后2周内接受外科手术治疗,以术后病理诊断结果为“金标准”,探讨高分辨率MRI、ADC值联合应用于直肠癌术前分期评估中的应用效果。结果 术后病理确诊98例直肠癌患者中Ⅰ期38例,Ⅱ期46例,Ⅲ期14例。高分辨率MRI评估直肠癌术前分期与金标准一致性一般(Kappa值为0.695);高分辨率MRI联合ADC值评估直肠癌术前分期结果与金标准一致性好(Kappa值为0.865)。高分辨率MRI、高分辨率MRI联合ADC值评估直肠癌术前分期的准确率分别为81.63%、91.84%。对比两种方法评估直肠癌术前分期准确率,高分辨率MRI联合ADC值>高分辨率MRI(χ^(2)=4.434;P=0.035)。对比不同术后病理分期直肠癌患者ADC值,Ⅰ期>Ⅱ期>Ⅲ期,差异有统计学意义(P<0.05)。结论 高分辨率MRI联合ADC值评估直肠癌术前分期的效能较高,可为临床治疗提供依据。

Objective To explore the application effect of high-resolution magnetic resonance imaging(MRI)combined with apparent diffusion coefficient(ADC)values in preoperative evaluation of rectal cancer patients.Methods 98 rectal cancer pa-tients who were scheduled to undergo surgical treatment at the Second Hospital of Qinhuangdao were selected as the study sub-jects.All patients underwent high-resolution MRI and diffusion-weighted imaging(DWI)before surgery,with ADC values re-corded.Within 2 weeks after the completion of the examination,surgical treatment was performed,and the postoperative patho-logical diagnosis was used as the“gold standard”to explore the efficacy of high-resolution MRI combined with ADC value in evaluating preoperative staging of rectal cancer.Results Postoperative pathological diagnosis confirmed that among 98 patients with rectal cancer,38 cases were stage I,46 cases were stage II,and 14 cases were stage III.The consistency between high-resolution MRI evaluation of preoperative staging of rectal cancer and the gold standard was average(Kappa value was 0.695).The preoperative staging results of rectal cancer evaluated by high-resolution MRI combined with ADC value were consistent with the gold standard(Kappa value was 0.865).The accuracy rates of high-resolution MRI and high-resolution MRI combined with ADC value in evaluating preoperative staging of rectal cancer were 81.63%and 91.84%,respectively.Comparison of two methods for evaluating the accuracy of preoperative staging of rectal cancer,high-resolution MRI combined with ADC value>high-resolution MRI(χ^(2)=4.434,P=0.035).The ADC values of rectal cancer patients with different postoperative pathological stages were compared(P<0.05).Conclusion The combination of high-resolution MRI and ADC values is highly effective in evaluating preoperative staging of rectal cancer,which can provide a basis for the development of clinical treatment plans for rectal cancer.