Radiology Department, Yuzuncu Yil University, Ercis Yolu, Van, Turkey.
Jpn J Radiol. 2014 Jan;32(1):6-13. doi: 10.1007/s11604-013-0260-2. Epub 2013 Nov 1.
The purpose of our study was to assess the efficiency of diffusion-weighted magnetic resonance imaging (DW-MRI) and the quantification of apparent diffusion coefficient (ADC) values in differentiating colorectal carcinoma from colonic inflammatory bowel disease (IBD) in cases with isolated colonic wall lesions and uncertain clinical and radiologic diagnostic criteria.
The study comprised 58 patients with segmental or focal isolated colonic wall thickening. All lacked satisfactory clinical-radiological findings for etiology determination. The mean ADC values of the thickened colonic walls were retrospectively compared with final histopathologic diagnoses. Receiver operating characteristic (ROC) curve analysis was used to determine the ADC cutoff value for differentiation.
Mean ADC value in the colorectal carcinoma group was significantly lower than that in the IBD group: n = 27, 1.02 ± 0.26 × 10(-3) mm(2)/s; and n = 31, 1.53 ± 0.19 × 10(-3) mm(2)/s, respectively (P < 0.001). Cutoff ADC value for differentiating colorectal carcinoma from IBD was calculated as 1.39 × 10(-3) mm(2)/s, with 83.9 % sensitivity and 85.2 % specificity.
ADC measurement of the involved colonic wall segments with DW-MRI has the potential to differentiate isolated colonic IBD from colorectal carcinoma in cases in which clinical-radiologic findings are insufficient for a definitive diagnosis.
我们的研究目的是评估弥散加权磁共振成像（DW-MRI）和表观扩散系数（ADC）值的定量分析在区分孤立性结肠壁病变且临床和影像学诊断标准不确定的结直肠癌与结直肠炎症性肠病（IBD）中的效率。
该研究纳入了 58 例节段性或局灶性孤立性结肠壁增厚患者。所有患者均缺乏病因确定的满意临床-影像学发现。回顾性比较增厚结肠壁的平均 ADC 值与最终组织病理学诊断。采用受试者工作特征（ROC）曲线分析确定区分的 ADC 截断值。
结直肠癌组的平均 ADC 值明显低于 IBD 组：n = 27，1.02 ± 0.26×10(-3)mm(2)/s；n = 31，1.53 ± 0.19×10(-3)mm(2)/s，差异具有统计学意义（P < 0.001）。区分结直肠癌与 IBD 的 ADC 截断值计算为 1.39×10(-3)mm(2)/s，具有 83.9%的敏感性和 85.2%的特异性。
DW-MRI 对受累结肠壁节段 ADC 值的测量有助于在临床和影像学表现不足以明确诊断的情况下，区分孤立性结肠 IBD 与结直肠癌。
