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[联合T2加权和弥散加权磁共振成像用于直肠癌分期]

[Combined T2-weighted and diffusion-weighted MR imaging for staging of rectal cancers].

作者信息

Zhang C D, Zhang H M, Meng Y K, Ye F, Jiang J, Ouyang H, Zhao X M, Zhou C W

机构信息

Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2018 Jan 23;40(1):46-51. doi: 10.3760/cma.j.issn.0253-3766.2018.01.008.

Abstract

To compare the diagnostic value of T2 weighted imaging (T2WI), diffusion-weighted imaging (DWI), and T2WI+ DWI magnetic resonance imaging (MRI) for staging of rectal cancers for improving the accuracy of tumor staging. From January 2011 to December 2013, 120 cases of rectal cancers proved by colonoscopy without receiving any anti-tumor treatment were enrolled retrospectively. The MRI data for these patients were divided into three groups, ie., T2WI, DWI and T2WI+ DWI, for evaluating the tumor stages. The results were compared with histopathologic findings. The sensitivity and specificity were calculated and compared with chi-square test. The nodal staging was predicted by using T2WI+ DWI. The accuracy for prediction of tumor staging was 83.3%, 65.0% and 92.5% for T2WI, DWI, and T2WI+ DWI respectively. The specificity for evaluating T1 and T2 stage, and the sensitivity for evaluating T3 by DWI was significantly lower than those using T2WI and T2WI+ DWI in rectal cancers. The sensitivity for evaluation of T2 by DWI was lower than that using T2WI+ DWI (63.0% vs. 88.9%). The sensitivity for evaluation T2 and specificity for T3 by T2WI+ DWI was higher than thouse using T2WI only (88.9% vs. 51.9%, 94.0% vs. 72.0%). The accuracy for prediction of nodal staging by using T2WI+ DWI was 62.1% (72/116). T2WI is the key sequence for staging of rectal cancers. Although the diagnostic accuracy was not good by using DWI alone, the combination of T2WI and DWI can improve the accuracy significantly for tumor staging in rectal cancers, whereas the nodal staging was still a hard task for radiologists.

摘要

比较T2加权成像(T2WI)、弥散加权成像(DWI)以及T2WI + DWI磁共振成像(MRI)在直肠癌分期中的诊断价值,以提高肿瘤分期的准确性。回顾性纳入2011年1月至2013年12月期间120例经结肠镜检查证实且未接受任何抗肿瘤治疗的直肠癌患者。将这些患者的MRI数据分为三组,即T2WI组、DWI组和T2WI + DWI组,用于评估肿瘤分期。将结果与组织病理学结果进行比较。计算敏感性和特异性,并采用卡方检验进行比较。使用T2WI + DWI预测淋巴结分期。T2WI、DWI和T2WI + DWI对肿瘤分期预测的准确率分别为83.3%、65.0%和92.5%。在直肠癌中,DWI评估T1和T2期的特异性以及评估T3期的敏感性显著低于使用T2WI和T2WI + DWI。DWI评估T2期的敏感性低于使用T2WI + DWI(63.0%对88.9%)。T2WI + DWI评估T2期的敏感性和T3期的特异性高于仅使用T2WI(88.9%对51.9%,94.0%对72.0%)。使用T2WI + DWI预测淋巴结分期的准确率为62.1%(72/116)。T2WI是直肠癌分期的关键序列。虽然单独使用DWI诊断准确性不佳,但T2WI与DWI联合可显著提高直肠癌肿瘤分期的准确性,而淋巴结分期对放射科医生来说仍然是一项艰巨的任务。

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