[目的]探讨高分辨磁共振(high-resolution magnetic resonance imaging,HR-MRI)及弥散加权成像(diffusion-weighted imaging,DWI)在直肠癌分期及分级中的应用价值.[方法]选取45例直肠癌患者,均行直肠HR-MRI平扫、DWI以及增强扫描,以病理分期结果为金标准,对比HR-MRI及HR-MRI+增强扫描对直肠癌T分期的诊断准确性.采用受试者工作特征(receiver operating characteristic,ROC)曲线分析两者对直肠癌的诊断效能.分析表观扩散系数(apparent diffusion coefficient,ADC)与直肠癌病理分化程度的相关性.[结果]45例直肠癌患者均取得病理结果,HR-MRI对直肠癌T分期共误诊14例,HR-MRI+增强扫描共误诊8例,HR-MRI+增强扫描对直肠癌的T分期的诊断效能优于单独HR-MRI.随直肠癌肿瘤病理分化程度升高,平均ADC值随之升高(b=800 s/mm2∶F=25.344,P＜0.001;b=1 000 s/mm2∶F=14.769,P＜0.001).[结论]HR-MRI 对直肠癌 T 分期具有较好的术前诊断价值,联合增强扫描可进一步提高其诊断效能.ADC值对直肠癌病理分化程度有一定的预测价值.
Application of High-Resolution Magnetic Resonance Imaging and Diffusion-Weighted Imaging in Preoperative Staging and Grading of 45 Cases with Rectal Cancer
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