HRMRI联合IVIM-DWI对直肠癌壁外血管侵犯的诊断价值分析

Diagnostic Value of HRMRI Combined with IVIEM-DWI on Extramural Vascular Invasion of Rectal Cancer

目的探究高分辨率磁共振成像(HRMRI)联合体素内不相干运动扩散加权成像(IVIM-DWI)对直肠癌壁外血管侵犯(EMVI)的诊断价值。方法选取2020年5月至2023年5月我院收治的直肠癌患者82例,术前均进行HRMRI联合IVIM-DWI检查,根据术后病理检查结果,观察患者EMVI评分情况,将患者分为EMVI组和非EMVI组,比较两组IVIM-DWI相关参数[快弥散系数(D)和灌注分数(f)]差异,分析HRMRI、IVIM-DWI单独及联合应用对EMVI的诊断价值。结果82例直肠癌患者中,EMVI评分3分、4分的数量分别为19例(23.17%)和13例(15.85%);术后病理结果显示,82例直肠癌患者中有37例(45.12%)出现EMVI,EMVI组患者D、f均高于与非EMVI组患者(P<0.05);HRMRI、IVIM-DWI单独诊断EMVI阳性患者分别为32例(39.02%)、41例(50.00%),联合诊断EMVI阳性患者48例(58.54%);HRMRI、IVIM-DWI单独诊断EMVI的灵敏度分别为67.56%、75.68%,特异度分别为84.44%、71.11%,联合诊断灵敏度为91.89%,特异度为68.88%,Kappa一致性分析结果显示,HRMRI、IVIM-DWI单独、联合诊断EMVI的kappa值分别为0.526、0.463、0.592。结论HRMRI、IVIM-DWI均对直肠癌患者EMVI的诊断具有一定诊断价值,二者联合应用诊断效能更高,值得推广应用。

Objective To explore the diagnostic value of high-resolution magnetic resonance imaging(HRMRI)combined with intravoxel incoherent motion diffusion weighted imaging(IVIEM-DWI)on extramural vascular invasion(EMVI)of rectal cancer.Methods 82 patients with rectal cancer admitted to our hospital from May 2020 to May 2023 were selected.HRMRI combined with IVIM-DWI were performed before surgery.According to the postoperative pathological examination results,the EMVI score of patients was observed,and the patients were divided into EMVI group and non-EMVI group.The differences in IVIIM-DWI parameters[fast diffusion coefficient(D)and perfusion fraction(f)]were compared between the two groups,and the diagnostic value of HRMRI and IVIim-DWI alone and combined application on EMVI was analyzed.Results Among 82 patients with rectal cancer,there were 19 cases(23.17%)with EMVI score of 3 points and 13 cases(15.85%)with EMVI score of 4 points.Postoperative pathological results showed that 37 cases(45.12%)of 82 patients with rectal cancer had EMVI,and the D and f in EMVI group were higher than those in non-EMVI group(P<0.05).There were 32 cases(39.02%)and 41 cases(50.00%)of EMVI positive patients diagnosed by HRMRI and IVIM-DWI alone,and there were 48 cases(58.54%)of EMVI positive patients diagnosed by combined application.The sensitivities of HRMRI and IVIM-DWI in the diagnosis of EMVI were 67.56%and 75.68%and the specificities were 84.44%and 71.11%respectively.The sensitivity and specificity of combined diagnosis were 91.89%and 68.88%respectively.Kappa consistency analysis showed that the kappa values of HRMRI,IVIEM-DWI alone and combined application in diagnosing EMVI were 0.526,0.463 and 0.592 respectively.Conclusion Both HRMRI and IVIEM-DWI have certain diagnostic value in the diagnosis of EMVI in patients with rectal cancer,and the combined application of the two has higher diagnostic efficiency.