3.0 T磁共振体素内不相干运动成像参数在直肠癌与直肠管状绒毛状腺瘤鉴别诊断中的应用

目的评价3.0 T磁共振成像体素内不相干运动成像(intravoxel incoherent motion,IVIM)在直肠管状绒毛状腺瘤和直肠癌鉴别诊断中的作用。材料与方法收集2016年6月-2017年6月苏州大学附属第一医院经病理证实的11例直肠管状绒毛状腺瘤和30例直肠癌患者,两组均于术前行3.0 T磁共振成像常规序列及IVIM扫描,在后处理软件上测量直肠管状绒毛状腺瘤和直肠癌的真实扩散系数(D)、灌注相关扩散系数(D~*)、灌注分数(f)及表观扩散系数(apparent diffusion coefficient,ADC)值,运用统计学软件比较两组参数的差异性,并分析有差异的参数值对直肠癌与直肠管状绒毛状腺瘤的诊断效能。结果直肠癌组D值、ADC值低于直肠管状绒毛状腺瘤组,且差异均有统计学意义(P0.05)。直肠癌组D~*值的平均值高于直肠管状绒毛状腺瘤组,但差异无统计学意义(P0.05)。两组间f值差异无统计学意义(P0.05)。以ADC1.026×10~(-3) mm~2/s作为诊断直肠癌的阈值时,其敏感性和特异性分别为81.8%、70%;以D值0.788×10~(-3) mm~2/s作为诊断直肠癌的阈值时,其敏感性和特异性分别为87.9%、71.1%。结论 IVIM参数D值和标准ADC值对直肠癌与直肠管状绒毛状腺瘤的鉴别诊断具有参考价值。

Application of intravoxel incoherent motion imaging of 3.0 T magnetic resonance imaging on the identification rectal tubulovillous adenoma and rectal cancer

Objective: To evaluate the role of differential diagnosis of 3.0 T intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) on rectal tubulovillous adenoma and rectal cancer. Materials and methods: 11 cases of rectal tubulovillous adenoma and 30 cases of rectal cancer patients (confirmed by pathology) were enrolled in this study between June 2016 and June 2017 at the First Affiliated Hospital of Soochow University 3.0 T MRI normal sequences and IVIM examination in the two groups before surgery. Perfusion-related diffusion coefficient (D), real diffusion coefficient (D), perfusion fraction (f) and apparent diffusion coefficient (ADC) were measured on the post-processing software, and D, D, f and ADC values were compared respectively to analyze the diagnosis efficiency of each parameter of rectal tubulovillous adenoma and rectal cancer. Results: The D value and standard ADC value of rectal cancer group were lower than those of rectal tubulovillous adenoma group, and the difference was statistically significant (all P<0.05). The mean value of D was higher than that of rectal tubulovillous adenoma group, but the difference was not statistically significant (P>0.05). There was no significant difference between the two groups (P>0.05). The cut-off value for rectal tubulovillous adenoma and rectal cancer was ADC<1.026×10-3 mm2/s, the sensitivity and specificity was 81.8%, 70%; D<0.788×10-3 mm2/s, the sensitivity and specificity was 87.9%, 71.1%. Conclusions: D and ADC value have reference value for identification of diagnosis of rectal cancer and rectal tubulovillous adenoma.