3D-SPACE联合DWI序列在直肠癌术前评估固有肌层突破的价值

The Value of 3D-SPACE Combined with DWI in Preoperatively Assessing Muscularis Propria Invasion in Rectal Cancer

摘要: 目的：探讨高分辨率三维可变翻转角快速自旋回波序列(3D-SPACE)诊断直肠癌术前固有肌层突破的价值。方法：选取2019年1月至2023年6月直肠癌术后确诊的55例直肠癌患者MRI资料，所有患者均行3D-SPACE、DWI序列检查。以病理结果为金标准，比较单独序列及联合序列诊断术前直肠癌肌层突破准确性、敏感性、特异性、阳性、阴性预测值，采用Kappa检验比较它们与病理结果的一致性；结果：单一序列与联合序列诊断的准确性、特异性、阳性、阴性预测值分别为78.2%、84.4%、69.6%、79.4%、76.2%，及87.3%、90.9%、81.8%、88.2%、85.7%；Kappa值分别为0.55及0.73。结论：3D-SPACE联合DWI序列能够提高术前MRI诊断直肠癌术前肌层突破准确性，为临床治疗方法提供参考。

Abstract: Objective: To evaluate the value of high-resolution three-dimensional variable flip-angle fast spin-echo (3D-SPACE) sequence in diagnosing muscularis propria invasion in preoperative rectal cancer. Methods: MRI data of 55 patients with pathologically confirmed rectal cancer after surgery, collected from January 2019 to June 2023, were analyzed. All patients underwent 3D-SPACE and DWI (Diffusion-Weighted Imaging) sequences. Using pathological findings as the gold standard, the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of individual sequences and the combined sequence were compared. Consistency with pathological results was assessed using Kappa statistic. Results: The diagnostic accuracy, specificity, PPV, and NPV for the individual sequence and the combined sequence were 78.2%, 84.4%, 69.6%, 79.4%, 76.2% and 87.3%, 90.9%, 81.8%, 88.2%, 85.7%, respectively. The Kappa values were 0.55 and 0.73, respectively. Conclusion: The combination of 3D-SPACE and DWI sequences can improve the accuracy of preoperative MRI in diagnosing muscularis propria invasion in rectal cancer, providing valuable reference for clinical treatment planning.