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目的探讨磁共振弥散加权成像(DWI)结合常规序列在直肠癌诊断及分期中的临床价值。方法29例经内镜诊断为直肠癌的患者及15例未患直肠癌的对照组行DWI及磁共振常规序列扫描。两名医师采用盲法阅片诊断。以受试者操作特性曲线(ROC)分析单独使用常规序列及DWI结合常规扫描序列诊断直肠癌的敏感性及特异性。结果单独使用常规序列的ROC曲线下面积分别为0.915和0.930,DWI结合常规序列的ROC曲线下面积分别为0.990和0.994,两种方案均为诊断直肠癌的有效方法。DWI结合常规扫描序列对直肠癌诊断的准确性显著高于单独使用常规扫描序列(P(0.05)。两名医师单独使用常规序列的Kappa值为0.850,采用DWI结合常规扫描序列的Kappa值为0.858。结论DWI是使用常规序列诊断直肠癌的必要补充。
Objective To investigate the clinical value of diffusion weighted imaging (DWI) combined with routine sequencing in the diagnosis and staging of rectal cancer. Methods Twenty-nine patients with endoscopic diagnosis of rectal cancer and 15 patients without rectal cancer underwent DWI and MRS scan. Two physicians used blinded readings to diagnose. The receiver operating characteristic curve (ROC) analysis was used to diagnose the sensitivity and specificity of rectal cancer using conventional sequence alone and DWI combined with routine scanning sequence. Results The area under the ROC curve of the conventional sequence alone was 0.915 and 0.930, respectively. The area under the ROC curve of the conventional combined sequence with DWI was 0.990 and 0.994, respectively. Both of the two regimens were effective methods for the diagnosis of rectal cancer. The diagnostic accuracy of DWI combined with routine scan was significantly higher than that of conventional scan (P (0.05)). The Kappa values of two physicians with conventional sequences alone were 0.850 and those with DWI combined with conventional sequences were 0.858 .Conclusion DWI is a necessary complement to the diagnosis of rectal cancer using routine sequence.