摘要
目的 探讨MR扩散加权成像(DWI)联合动态增强扫描(DCE-MRI)对直肠癌分化程度及神经脉管侵犯的评估价值.方法 选取直肠癌患者 85 例,依据组织病理学诊断,将其中伴神经和脉管侵犯的 33 例作为观察组,不伴神经和脉管侵犯的 52 例作为对照组,均接受MR常规序列、DWI联合DCE扫描.比较两组及不同分化程度瘤体的ADC、eADC及PEI、TTP、MTE、SER、MSI值的差异;比较瘤体ADC值、eADC值、PEI值及三者联合对直肠癌神经脉管侵犯的诊断效能.结果 观察组瘤体ADC值显著低于对照组,eADC值、PEI值显著高于对照组,差异有统计学意义(P<0.05);低分化组瘤体ADC值显著低于中、高分化组,eADC值、PEI值显著高于中、高分化组(P<0.05).瘤体ADC值、eADC值、PEI值及三者联合对直肠癌神经脉管侵犯的诊断效能比较中,联合检测的灵敏度、准确度均高于三者单独检测,特异度高于eADC值、PEI值单独检测,差异有统计学意义(P<0.05).结论 应用DWI联合DCE-MRI对直肠癌患者进行扫描,能够有效评估其分化程度和神经脉管侵犯状况,临床价值较高.
Abstract
Objective To explore the value of MR diffusion-weighted imaging(DWI)combined with dynamic contrast-enhanced scanning(DCE-MRI)in the differentiation degree and neurovascular invasion of rectal cancer.Methods 85 patients with rectal cancer were selected.According to histopathological diagnosis,33 patients with nerve and vascular invasion were re-garded as the observation group,and 52 patients without nerve and vascular invasion were taken as the control group.All patients received routine MR sequence and DWI combined with DCE scanning.The ADC,eADC,PEI,TTP,MTE,SER and MSI values of the two groups and the tumors with different differentiation degrees were compared.The diagnostic efficacy of tumor ADC value,eADC value,PEI value and their combination for neurovascular invasion of rectal cancer were compared.Results The ADC value of tumor in the observation group was significantly lower than that in the control group,and the eADC value and PEI value were significantly higher than those in the control group(P<0.05).The ADC value of the poorly differentiated group was significantly lower than that of the moderately and well differentiated groups,and the eADC value and PEI value were signifi-cantly higher than those of the moderately and well differentiated groups(P<0.05).In the comparison of the diagnostic efficacy of tumor ADC value,eADC value,PEI value,and the combination of the three for neurovascular invasion of rectal cancer,the sensitivity and accuracy of the combined detection were higher than those of the three alone,and the specificity was higher than that of the eADC value and PEI value alone,with statistical significance(P<0.05).Conclusion The combination of DWI and DCE-MRI can effectively evaluate the degree of differentiation and neurovascular invasion of rectal cancer patients,and has high clinical value.
基金项目
浙江省嘉兴市科技计划项目(2022AD10012)
维普
万方数据