| 张海莲,涂文彬,王润强.磁共振成像在结直肠癌术后局部复发治疗方案中的临床价值[J].安徽医药,2019,23(5):961-964. |
| 磁共振成像在结直肠癌术后局部复发治疗方案中的临床价值 |
| Clinical value of magnetic resonance imaging in the treatment of postoperative local recurrence of colorectal cancer |
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| DOI：10.3969/j.issn.1009-6469.2019.05.034 |
| 中文关键词: 结直肠肿瘤 磁共振成像 肿瘤复发 ROC曲线 背景抑制核磁共振弥散加权成像 |
| 英文关键词: Colorectal neoplasms Magnetic resonance imaging Neoplasm recurrence ROC curve Clinical guidance value of magnetic resonance imaging |
| 基金项目: |
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| 摘要点击次数: 1877 |
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| 中文摘要: |
| 目的 探讨背景抑制核磁共振弥散加权成像联合核磁共振成像(DWIBS-MRI)对结直肠癌术后局部复发后治疗方案临床指导价值。方法 选择2012年8月至2017年8月入住青海省第五人民医院结直肠癌术后病人49例,根据检查结果分为复发组(n＝23)与非复发组(n＝26)。比较常规MRI和DWIBS-MRI在诊断结直肠癌术后复发以及转移的情况;此外,测定并比较复发组与非复发组受试者信号强度(SI)、表观扩散系数(ADC)、对比噪声比(CNR)。结果 MRI用于检测结直肠癌病人术后复发情况的灵敏度为82.61%(19/23),特异度为96.15%(25/26),假阴性率为17.39%(4/23),假阳性率为3.85%(1/26),正确率为89.80%(44/49),阳性预测值95.00%(19/20),阴性预测值86.21%(25/29)。DWIBS-MRI法用于检测结直肠癌病人术后复发情况的灵敏度为100.00%(23/23),特异度为96.15%(25/26),假阴性率为0.00%(0/23),假阳性率为3.85%(1/26),正确率为97.96%(48/49),阳性预测值95.83%(23/24),阴性预测值100.00%(25/25)。DWIBS-MRI特异度、假阳性率、阴性预测值与MRI组持平,灵敏度、假阴性率、正确率、阳性预测值优于MRI。复发组病人的信号强度以及表观扩散系数值为(434.18±201.21)、(1 306.44±561.68);非复发组病人的信号强度以及表观扩散系数值分别为(268.78±137.14)、(1 712.55±443.46);复发灶信号强度值高于非复发组,表观扩散系数值低于非复发组(P＜0.05)。复发组受试者的对比噪声比值高于非复发组［(67.12±16.06)比(22.88±5.80),P＜0.05］。结论 DWIBS-MRI是一种操作简单,安全无创的检测方法,对结直肠癌术后复发、淋巴结转移的监测敏感性较高。临床上可用DWIBS-MRI判断结直肠癌术后局部复发后治疗方案,具有一定的临床价值。 |
| 英文摘要: |
| Objective To investigate the clinical value of magnetic resonance imaging in the treatment of of colorectal cancer postoperative local recurrence of colorectal cancer.Methods During August 2012 to August 2017,49 cases of postoperative patients with colorectal cancer hospitalized in the Fifth People’s Hospital of Qinghai Province were chosen for research object according to the test results,and were divided into relapse group (n＝23) and non-relapse group (n＝26).Comparison conventional MRI with DWIBS-MRI in the diagnosis of postoperative recurrence and metastasis of colorectal cancer.In addition,the determination and compare the relapse group and recurrence group subjects signal intensity (SI),apparent diffusion coefficient (ADC) and contrast to noise ratio (CNR) were measured and compared between the relapsed group and the non-relapsed group.Results The sensitivity,specificity,false negative rate,false positive rate,correct rate,positive predictive value and negative predictive value of MRI in detecting recurrence of colorectal cancer patients were 82.61% (19/23),96.15% (25/26),17.39% (4/23),3.85% (1/26),89.80% (44/49),95.00% (19/20) and 86.21% (25/29),respectively.The sensitivity,specificity,false negative rate,false positive rate and accuracy of DWIBS-MRI in detecting postoperative recurrence of colorectal cancer patients were 100.00% (23/23),96.15% (25/26),0.00% (0/23),3.85% (1/26),97.96% (48/49),95.83% (23/24) and 100.00% (25/25),respectively.The specificity,false positive rate and negative predictive value of DWIBS-MRI were the same as those of MRI group.The sensitivity,false negative rate,correct rate and positive predictive value of DWIBS-MRI were better than those of MRI group.The SI and ADC of relapsed patients were (434.18±201.21) and (1 306.44±561.68).The SI and ADC of non-relapse group were (268.78±137.14) and (1 712.55±443.46),respectively.The SI of recurrence focus was higher than that of non-relapse group,and the ADC was lower than that of non-relapse group (P＜0.05).The CNR of the relapsed group was higher than that of the non-relapsed group ［(67.12±16.06) vs. (22.88±5.80),P＜0.05］.Conclusions DWIBS-MRI is a simple,safe and non-invasive method,with high sensitivity to detect recurrence of colorectal cancer and lymph node metastasis.DWIBS-MRI can be used in clinical diagnosis of postoperative local recurrence of colorectal cancer. |
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