磁共振体素内不相干运动-扩散加权成像在直肠癌术前诊断中的应用价值
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摘要
为探讨磁共振(MRI)体素内不相干运动-扩散加权成像(IVIM-DWI)在直肠癌术前诊断中的应用价值,回顾2015年7月至2017年11月我院收治的术后病理证实为直肠癌且术前曾接受MRI IVIM-DWI检查的58例患者资料,分析直肠癌组织与正常直肠组织、不同病理分期及不同组织分化程度肿瘤组织之间表观扩散系数(ADC)、慢扩散ADC值(D)、快扩散ADC值(D*)、灌注分数(f)等参数的差异。结果显示,与正常直肠组织相比,直肠癌组织ADC、D均明显降低(P <0.05),而D*明显升高(P <0.05),f无明显差异(P>0.05)。不同病理分期直肠癌组织之间,病理分期越高,D越低,差异显著(P <0.05);而ADC、D*、f比较均无明显差异(P>0.05)。不同组织分化程度直肠癌组织之间,分化程度越高,ADC、D越高,差异显著(P <0.05);而D*、f比较均无明显差异(P>0.05)。结果表明,MRI IVIM-DWI技术提供的ADC、D、D*、f等参数可在一定程度上反映肿瘤的病理生理状态,尤其是D值,对于评估直肠癌分期及分化程度有重要意义。
In order to estimate the application value of MRI intravoxal incoherent motion-diffusion weighted imaging(IVIM-DWI)for preoperatively diagnosing rectal cancer,author retrospectively analyzed the data of 58 cases who were admitted and had been confirmed by postoperatively pathological findings as rectal cancer,and received MRI IVIM-DWI inspection from 2015-07 to 2017-11 in author's hospital,included and analysed their differences in ADC,D,D*and f,etc parameters between cancer tissue and normal rectal one,between those neoplasms tissues at different pathological stagings,and at different tissue differentiation degrees.As results,compared with normal tissue,rectum cancers' ADC,D were all significantly declined(P <0.05),but D*significantly uplifted(P <0.05),f value had no significantly difference(P >0.05);among cancer tissues at different pathological stagings,more higher of the stagings,more lower of the D,significant difference(P <0.05),but in ADC,D*and f,there was no significant difference(P >0.05);among cancer tissues at different differentiation degree,more higher of the degree,more higher of the ADC and D,significant difference(P <0.05),but in D*,f there was no significant difference(P >0.05).Results show that to a certain extent,ADC,D,D*and f etc parameters provided by MRI IVIM-DWI can reflect the patho-physical situation of neoplasms,especialy D value,thus it has important significance for estimating staging and differentiation degree of rectal cancer.
In order to estimate the application value of MRI intravoxal incoherent motion-diffusion weighted imaging(IVIM-DWI)for preoperatively diagnosing rectal cancer,author retrospectively analyzed the data of 58 cases who were admitted and had been confirmed by postoperatively pathological findings as rectal cancer,and received MRI IVIM-DWI inspection from 2015-07 to 2017-11 in author's hospital,included and analysed their differences in ADC,D,D*and f,etc parameters between cancer tissue and normal rectal one,between those neoplasms tissues at different pathological stagings,and at different tissue differentiation degrees.As results,compared with normal tissue,rectum cancers' ADC,D were all significantly declined(P <0.05),but D*significantly uplifted(P <0.05),f value had no significantly difference(P >0.05);among cancer tissues at different pathological stagings,more higher of the stagings,more lower of the D,significant difference(P <0.05),but in ADC,D*and f,there was no significant difference(P >0.05);among cancer tissues at different differentiation degree,more higher of the degree,more higher of the ADC and D,significant difference(P <0.05),but in D*,f there was no significant difference(P >0.05).Results show that to a certain extent,ADC,D,D*and f etc parameters provided by MRI IVIM-DWI can reflect the patho-physical situation of neoplasms,especialy D value,thus it has important significance for estimating staging and differentiation degree of rectal cancer.
引文
[1]韩帅,邵楠楠,曲金荣.体素内不相干运动序列磁共振成像在直肠癌诊断中应用价值[J].山东医药,2016,56(25):64-66.
[2]王智君,张志伟.3.0T磁共振体素内不相干运动扩散加权成像参数对直肠癌患者术前的指导价值[J].中国CT和MRI杂志,2018,16(3):103-106.
[3]刘荫华,徐玲.第七版《AJCC肿瘤分期手册》结直肠癌内容的更新与解读[J].中华胃肠外科杂志,2010,13(8):629-631.
[4]信超,孙轶群,毛健,等.体素内不相干运动扩散加权成像在预测局部进展期直肠癌新辅助放化疗疗效中的初步研究[J].中国癌症杂志,2017,27(12):985-991.
[5]白毓,罗鸣,张鹏.磁共振IVIM-DWI及DCE-MRI在直肠癌诊断中的应用价值[J].解放军医药杂志,2017,29(7):89-92,96.
[2]王智君,张志伟.3.0T磁共振体素内不相干运动扩散加权成像参数对直肠癌患者术前的指导价值[J].中国CT和MRI杂志,2018,16(3):103-106.
[3]刘荫华,徐玲.第七版《AJCC肿瘤分期手册》结直肠癌内容的更新与解读[J].中华胃肠外科杂志,2010,13(8):629-631.
[4]信超,孙轶群,毛健,等.体素内不相干运动扩散加权成像在预测局部进展期直肠癌新辅助放化疗疗效中的初步研究[J].中国癌症杂志,2017,27(12):985-991.
[5]白毓,罗鸣,张鹏.磁共振IVIM-DWI及DCE-MRI在直肠癌诊断中的应用价值[J].解放军医药杂志,2017,29(7):89-92,96.