摘要
目的探讨动态增强磁共振成像(DCE-MRI)定量参数、体素内不相干运动(IVIM)不同模型在直肠癌病理分级中的应用价值,比较两者灌注指标的相关性。资料与方法收集行动态增强及多b值扩散加权成像扫描,且经手术或肠镜病理证实为直肠癌的37例患者,其中高分化11例,中分化12例,低分化14例,测量DCE-MRI参数容积转移常数(K^trans)、速率常数(Kep)和血管外细胞外容积分数(Ve),IVIM模型中标准表观扩散系数(标准ADC)、双阶单指数纯扩散系数(D-mono)、灌注系数(D^*-mono)、灌注分数(f-mono)及双阶双指数模型纯扩散系数(D-Bi)、灌注系数(D^*-Bi)、灌注分数(f-Bi),检验数据一致性,比较不同病理分化程度直肠癌各参数值的差异及各组间参数值的差异,分析各灌注指标间的相关性。结果观察者间测量数据一致性良好(ICC>0.5)。DCE-MRI参数K^trans、Ve值及IVIM模型参数D-mono及D^*-mono值在不同病理分级的直肠癌中差异有统计学意义(P<0.05),低分化组Ktrans及Ve值均高于高分化组;低分化组D-mono值低于高分化组,D*-mono值高于高分化组,且随着分化程度降低,D-mono值逐渐降低,D^*-mono值逐渐升高,差异有统计学意义(P<0.05);Ve与f-Bi呈正相关(r=0.365,P=0.026)。结论DCE-MRI及IVIM模型可为直肠癌病理分级的术前评估提供较可靠的定量参数。IVIM模型的f-Bi值与DCE-MRI灌注参数Ve具有相关性。
Purpose To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters and different Intravoxel Incoherent Motion Models(IVIM)in the pathological grading of rectal cancer,and to compare the correlation of perfusion indexes.Materials and Methods Thirty-seven patients with rectal cancer confirmed by surgery or enteroscopy pathology were enrolled,all patients underwent dynamic enhancement and multiple b-value diffusion-weighted imaging scans,including 11 cases of highly differentiated,12 cases of moderately differentiated and 14 cases of poorly differentiated.The mean value of DCE-MRI(K^trans,Ve,Kep),eDWI(Standard ADC,D-mono,D^*-mono,f-mono,D-Bi,D*-Bi,f-Bi)were measured.The consistency of the data was tested by ICC,the differences in parameter values of rectal cancer with different degrees of pathological differentiation and the differences in parameter values among groups were analyzed,and the correlation between perfusion indexes was also analyzed.Results The consistency of measurement data between observers was good(ICC>0.5).DCE-MRI parameters Ktrans,Ve and IVIM model parameters D-mono and D*-mono were statistically significant in different pathological grades of rectal cancer(P<0.05),the K^trans and Ve of the poorly differentiated group were higher than those of the highly differentiated group;the D-mono value of the poorly differentiated group was lower than that of the highly differentiated group,and the D^*-mono value was higher than that of the highly differentiated group,and as the degree of differentiation decreased,the D-mono value gradually decreased and the D^*-mono value gradually increased,with statistical difference(P<0.05);Ve was positively correlated with f-Bi(r=0.365,P=0.026).Conclusion DCE-MRI and IVIM models can provide more reliable quantitative parameters for preoperative evaluation of rectal cancer pathological grade.The f-Bi value of the IVIM model is correlated with the DCE-MRI perfusion parameter Ve.
作者
刘晓冬
刘爱连
李烨
田士峰
韩铮
赵莹
徐明哲
LIU Xiaodong;LIU Ailian;LI Ye;TIAN Shifeng;HAN Zheng;ZHAO Ying;XU Mingzhe(First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2020年第4期256-259,268,共5页
Chinese Journal of Medical Imaging
关键词
直肠肿瘤
磁共振成像
图像处理
计算机辅助
肿瘤分级
病理学
外科
Rectal neoplasms
Magnetic resonance imaging
Image processing
computer-assisted
Neoplasm grading
Pathology
surgical
