摘要
目的：探讨磁共振背景抑制弥散加权成像（diffusionweightedimagingwithbackgroundsignalsuppression。DWIBS）结合常规序列在直肠癌局部切除中的临床价值。方法：选取2009—03—05—2012—10—18潍坊医学院附属医院收治的42例早期低位直肠癌患者，行DWIBS及磁共振常规序列扫描。根据扫描结果采取局部切除术或腹会阴联合切除术，并与术后组织病理学结果进行比较，分析DWIBS及磁共振常规序列扫描在早期低位直肠癌局部切除中的临床应用价值。结果：42例术前磁共振检查拽诊断为直肠癌患者，经术后组织病理学确诊，术前诊断准确率为100．0％。T分期总的诊断准确率为76．2％（32／42）；对T1期的诊断准确率为76．2％（32／42），特异性为93．8％（15／16），敏感性为65．4％（17／26）；对T2的诊断准确率为76．2％（32／42），特异性为66．7％（18／27），敏感性为93．3％（14／15）；对T3期的诊断准确率为i00．0％（42／42），特异性为100．0％（41／41），敏感性为1／1。对25例腹会阴联合根治切除直肠癌病例N分期的总准确率为82．4％（28／34），其中短轴横径〉1．0cm的准确率为6／6，短轴横径为0．5～1．0cm的准确率为78．6％（22／28）。转移性和非转移性淋巴结的表观弥散系数（apparentdiffusioncoefficient，ADC）值差异有统计学意义，P=0．0476。结论：DWIBS结合常规序列可以快速完成直肠癌的诊断与术前分期，具有较高的准确性，可以作为对早期低位直肠癌患者选择局部切除术的有效依据之一。
OBJECTIVE：To evaluate the clinical value of diffusion weighted imaging with background signal suppres- sion （DWlBS） combined with conventional sequences of magnetic resonance for the local excision of rectal cancer. METH- ODS：DWlBS and conventional sequences were performed in 42 patients with lower rectal carcinoma of early stage. The pa- tients received transanal resection or abdominal peritoneum resection directed by magnetic resonance imaging and their his- topathology were compared. The clinical value of DWlBS combined with conventional sequences of magnetic resonance for local excision on lower rectal carcinoma of early stage was evaluated. RESULTS： The diagnosis with magnetic resonance was confirmed by postoperative histopathology. The accuracy of preoperative diagnosis of colorectal cancer with magnetic resonance was 100.0%. The accuracy rate of magnetic resonance was 76.2 % （32/42） for T staging in total. The accuracy rate of diagnosis was 76.2 % （32/42）, specificity was 93.8% （15/16） and sensibility was 65.4%//00 （17/26） for T1 staging. The accuracy rate of diagnosis was 76.2% （32/42）, specificity was 66.7% （18/27） and sensibility was 93.3 % （14/15） for T2 staging. The accuracy rate of diagnosis was 100.0% （42/42）, specificity was 100.0% （41/41） and sensibility was 1/1 for T3 staging. The accuracy rate of diagnosis, sensibility and specificity were 82.4% （28/34） for N staging in total, 6/6 for the lymph nodes whose short axis diameter was greater than 1.0 cm, 78.6 % （22/28） for the lymph nodes whose short axis diameter was in 0.5-- 1.0 cm. The diversity of ADC values between metastatic and non-metastatic lymph nodes had statististic significance （P= 0. 047 6）. CONCLUSIONS：The diagnosis of rectal cancer and preoperative tumor stage can becompleted quickly by DWIBS combined with conventional sequences of magnetic resonance and the accuracy rate is high. DWIBS combined with conventional sequences of magnetic resonance may be one of the effective select methods for pa tients with lower rectal carcinoma of early stage.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第5期377-379,共3页
Chinese Journal of Cancer Prevention and Treatment
基金
潍坊市科技局资助项目(201201242)
关键词
直肠肿瘤
局部切除
磁共振背景抑制弥散加权成像
磁共振成像
rectal neoplasms
local excision
diffusion weighted imaging with background signal suppression
magnet-ic resonance imaging
