Diagnostic value of MRI and DWI in local recurrence of rectal cancer after operation

SUN Zhaolong; SUN Aiguo; GUO Ying; ZHANG Lina; WANG Tie

doi:10.19732/j.cnki.2096-6210.2021.03.011

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Diagnostic value of MRI and DWI in local recurrence of rectal cancer after operation

更新时间：2025-12-15

- Diagnostic value of MRI and DWI in local recurrence of rectal cancer after operation
- Vol. 30, Issue 3, Pages: 204-208(2021)
- 作者机构：
  
  1. 河北省沧州中西医结合医院影像中心,河北
  2. ,沧州
  3. 河北省沧县医院影像科,河北
  4. 河北省沧州中西医结合医院介入科,河北
  5. 河北省沧州中西医结合医院胃肠外科,河北
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2021.03.011
  CLC：
- Published Online：28 June 2021，
  
  Published：28 June 2021
- 稿件说明：
移动端阅览
孙召龙,孙爱国,郭影,等. MRI与DWI在直肠癌术后局部复发中的诊断价值[J]. 肿瘤影像学, 2021, 30(3): 204-208 https://doi.

org/10.19732/j.cnki.2096-6210.2021.03.011
孙召龙,孙爱国,郭影,等. MRI与DWI在直肠癌术后局部复发中的诊断价值[J]. 肿瘤影像学, 2021, 30(3): 204-208 https://doi. DOI： 10.19732/j.cnki.2096-6210.2021.03.011.

org/10.19732/j.cnki.2096-6210.2021.03.011 DOI：

摘要

目的：

探讨常规磁共振成像（magnetic resonance imaging，MRI）和弥散加权成像（diffusion-weighted imaging，DWI）对直肠癌根治术后局部复发患者的诊断价值。

方法：

对74例直肠癌术后复发患者分别进行常规MRI和DWI检查，并以病理学检查结果为标准，应用受试者工作特征（receiver operating characteristic，ROC）曲线分析，比较两者的诊断效能差异。

结果：

直肠癌根治术后局部复发患者MRI表现，与正常肌肉组织相比较，肿瘤组织T1加权成像（T1-weighted imaging，T1WI）呈低、等信号，T2加权成像（T2-weighted imaging，T2WI）呈混杂高信号，DWI呈高亮信号，其表观弥散系数（apparent diffusion coefficient，ADC）值明显下降，且呈不均匀或环形强化。以病理学检查结果为标准，常规MRI诊断直肠癌术后复发患者的灵敏度、特异度、阳性预测值、阴性预测值、约登指数、误诊率和漏诊率分别为88.5%、86.4%、93.9%、76.0%、0.777、13.6%和11.5%；DWI的分别为98.1%、95.5%、98.1%、95.5%、0.938、4.5%和1.9%。经ROC曲线分析结果显示常规MRI诊断直肠癌根治术后患者局部复发的曲线下面积（area under curve，AUC）为0.874，DWI的AUC为0.968，DWI的AUC高于常规MRI。

结论：

与常规MRI相比，DWI对直肠癌根治术后患者局部复发的诊断价值更高，值得临床推广应用。

Abstract

Objective:

To investigate the diagnostic value of conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) for patients with local recurrence after radical operation for rectal cancer.

Methods:

A total of 74 patients with rectal cancer recurrence were diagnosed by conventional MRI a

nd DWI. The pathological diagnosis results were used as the standard

and the receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficiency of MRI and DWI.

Results:

Compared with normal muscle tissue

the MRI findings of patients with local recurrence after radical resection of rectal cancer showed that the tumor tissue showed low and equal signals on T1-weighted imaging (T1WI)

mixed high signals on T2-weighted imaging (T2WI)

and bright signals on DWI

and their apparent diffusion coefficient (ADC) values decreased significantlyand showed uneven or circular strengthening. Taking the pathological diagnosis as the standard

the sensitivity

specificity

positive predictive value

negative predictive value

Youden index

misdiagnosis rate and missed diagnosis rate of conventional MRI in diagnosis of patients with rectal cancer recurrence were 88.5%

86.4%

93.9%

76.0%

0.777

13.6% and 11.5%

respectively; DWI were 98.1%

95.5%

98.1%

95.5%

0.938

4.5% and 1.9%

respectively. ROC curve analysis showed that the area under curve (AUC) of MRI in diagnosis of patients with local recurrence after radical operation of rectal cancer was 0.874

AUC of DWI was 0.968

and AUC of DWI was higher than conventional MRI.

Conclusion:

Compared with conventional MRI

DWI is more valuable in the diagnosis of local recurrence of patients with rectal cancer after radical resection. It is worthy of clinical application.

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