【摘要】 目的 探讨3.0T MR体素内不相干运动扩散加权成像（IVIMDWI）参数与直肠中分化腺癌T分期的关系。方法 收集37例直肠中分化腺癌患者的直肠MRI图像（包括IVIMDWI序列）及临床资料；根据肿瘤是否突破固有肌层，将T分期分为未突破组（T1、T2期）和突破组（T3、T4期）;测量直肠癌与正常直肠壁真实扩散系数（D）、假扩散系数（D*）、灌注分数（f）和表观扩散系数（ADC）值，比较直肠癌与正常直肠壁，不同T分期，不同分组直肠癌各参数值之间的差异，分析IVIMDWI参数和ADC值与直肠中分化腺癌T分期的关系。结果 直肠癌的D、D*、f和ADC值均低于正常直肠壁，其中D、f和ADC值差异有统计学意义（P<0.05）;不同T分期肿瘤D和D*值的差异有统计学意义，LSD法两两比较显示T1期与T4期，T3期与T4期肿瘤的D*值差异有统计学意义（P=0.017、0.003）,T2期与T3期肿瘤D值差异有统计学意义（P=0.005）;未突破组与突破组肿瘤D值分别约（0.93±0.16）×10^-3 mm²/s、（0.77±0.19）×10^-3 mm²/s, D*值分别约（12.6±2.44）×10^-3 mm²/s、（12.3±3.49）×10^-3 mm²/s, f值分别约（27.1±2.94）%、（24.6±4.13）%,ADC值分别约（0.95±0.09）×10^-3 mm²/s、（0.87±0.12）×10^-3 mm²/s,其中D值的差异有统计学意义（t=2.512,P=0.017）。结论 IVIMDWI参数和ADC值能够区分直肠癌和正常直肠壁，D值可以辅助鉴别直肠癌是否突破固有肌层。更多还原

【Abstract】 Objective To investigate the relationships between the parameters of intravoxel incoherent motion(IVIM) DWI at 3.0Tesla and T staging of moderately differentiated adenocarcinoma of rectum.Methods Clinical data and MRI findings including conventional imaging and IVIM-DWI were collected in a total of 37 patients with moderately differentiated adenocarcinoma of rectum proven by pathology.The patients were divided into two groups without(staging T1 and T2) or with myometrial invasion(T3 and T4).The D,D~*,f and ADC values of rectal cancer and normal rectal wall were measured and were compared between the lesion and normal rectal wall,between both groups and among different T stages.The relationships of the parameters of IVIM-DWI and ADC values with the T staging of moderately differentiated adenocarcinoma of rectum were analyzed.Results The D,D~*,f and ADC values of rectal cancer were lower than those of normal rectal wall with statistical differences in D,f and ADC values(P<0.05).The differences in D and D~* values among different T stages were statistically significant,and LSD Duncan test showed that the difference in D~* value between T1 and T4(P=0.017) and between T3 and T4(P=0.003) and in D value between T2 and T3(P=0.005)were statistically significant.The D,f,D~* and ADC values of noninvasion group and invasion one were(0.93±0.16)×10~3 mm~2/s versus(0.77±0.19)×10~3mm~2/s,(27.1±2.94) % versus(24.6±4.13) %,(12.6±2.44)×10~3 mm~2/s versus(12.3±3.49)×10~3mm~2/s,and(0.95±0.09)×10~3 mm~2/s versus(0.87±0.12)×10~3mm~2/s respectively,and the difference in D value was statistically significant(t=2.512,P=0.017).Conclusion The parameters of IVIM-DWI and the ADC values are different in rectal cancer and normal rectal wall,and the D value may help to identify the tumor invasion into the muscularis propria.更多还原