MRI-DWI技术对直肠癌及术前分期的诊断价值分析

摘要

目的 探讨MRI增强扫描结合弥散加权成像对直肠癌诊断及术前评估的价值.方法 选取2016年1月~2016年11月期间我院接收的58例直肠癌患者,均行MRI增强扫描结合弥散加权成像检查,观察诊断价值.结果 b=1200s/m2时,高分化、中分化、低分化组间比较有明显差异( P <0.05);MRI结合DWI对于T期分期总诊断符合率为89.7%,与病理学T分期间一致性检验好(kappa=0.76);58例患者伴有39例淋巴结转移,MRI术前共检出可疑阳性淋巴结285枚,术后病理检查为223枚.转移性淋巴结ADC值显著高于良性淋巴结( P <0.05).结论 MRI-DWI对直肠癌进行诊断及分期有较高的价值,且有利于术前评估淋巴结的良恶性,以便于临床医师治疗方案的制定,具有推广价值.%Objective To evaluate the value of enhanced MRI scan combined with diffusion weighted imaging in the diagnosis and preoperative evaluation of rectal cancer. Methods 58 patients with rectal cancer in our hospital from January 2016 to No-vember 2016 were selected,all were treated with enhanced MRI scan and diffusion weighted imaging, and the diagnostic value was observed. Results There was a significant difference between the groups with high differentiation,middle differentiation and low differentiation when b=1 200 s/m2( P <0.05). MRI combined with DWI for the T staging of the total diagnostic accordance rate was 89.7%,and the consistency of the pathological T points during the test was well(Kappa=0.76). 58 patients presented with lymph node metastasis,285 cases of suspected positive lymph nodes were detected before MRI,postoperative pathological ex-amination was 223. ADC value of metastatic lymph nodes was significantly higher than that of benign lymph nodes( P <0.05). Conclusion MIR-DWI has high value in the diagnosis and staging of rectal cancer,and it is good for the preoperative evaluation of benign and malignant lymph nodes.