摘要
目的探讨动态对比增强磁共振成像(DCE-MRI)定量参数及表观扩散系数(ADC)值评估直肠癌分化程度及T分期的应用价值。方法搜集2017年11月至2019年11月期间就诊于四川省人民医院的直肠癌患者,测量其肿瘤的DCE-MRI定量参数,包括对比剂容量转换常数(Ktrans)、对比剂回流速率常数(Kep)、血管外细胞外容积分数(Ve)及ADC值,比较肿瘤不同分化程度和不同T分期直肠癌患者各参数值的差异,同时绘制受试者操作特征(ROC)曲线。结果本研究共纳入符合条件的患者53例,其中术后病理结果显示高分化13例,中分化30例,低分化10例;T1期5例,T2期8例,T3期24例,T4期16例。①不同分化程度直肠癌患者的Ktrans值和ADC值总体比较差异有统计学意义(P=0.004;P<0.001),而Kep、Ve值总体比较差异无统计学意义(P>0.050)。Ktrans值随着分化程度降低而升高(P<0.050),ADC值随着分化程度降低而降低(P<0.050)。②不同T分期直肠癌患者的Ktrans和ADC值总体比较差异有统计学意义(P=0.002;P=0.007),而Kep、Ve值总体比较差异无统计学意义(P>0.050)。Ktrans值和ADC值在T2与T3期直肠癌患者间比较差异有统计学意义(P=0.009;P=0.013)。③Ktrans值和ADC值区分高、中分化直肠癌的AUC值分别为0.677和0.763,其相应的最佳阈值分别为0.180/min和1.179 mm^2/s;Ktrans值和ADC值区分中、低分化直肠癌的AUC值分别为0.693和0.967,其相应的最佳阈值分别为0.281/min和0.906 mm^2/s。Ktrans值和ADC值区分T2、T3期直肠癌患者的AUC值分别为0.862和0.742,其相应的最佳阈值分别为0.204/min和1.579 mm^2/s。结论 DCE-MRI定量参数及ADC值术前判断直肠癌分化程度和T分期有一定的参考价值,通过统计学分析可以得到区分不同分化程度及T2–T3期的最佳Ktrans和ADC阈值。
Objective To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) quantitative parameters and apparent diffusion coefficient(ADC) value in evaluating the differentiation degrees and T stages of rectal cancer. Methods The patients with rectal cancer from November 2017 to November 2019 in the Sichuan Provincial People’s Hospital were collected. The volume transfer constant(Ktrans), flux rate constant(Kep), and extravascular extracellular volume fraction(Ve), and ADC values of the tumors were measured and compared in the patients with the different differentiation degrees and T stages. The receiver operating characteristic(ROC) curve analysis was performed. Results All of 53 eligible patients were included, including 13 cases of high differentiation, 30 cases of medium differentiation, and 10 cases of low differentiation;5 cases of T1 stage, 8 cases of T2 stage, 24 cases of T3 stage, and 16 cases of T4 stage. ① There were statistical differences in the Ktrans and ADC values among the different differentiation degrees of rectal cancer(P=0.004, P<0.001), and no statistical differences in the Kep and Ve values(P>0.050) among them. The Ktrans value was increased with decreased differentiation degree(P<0.050), the ADC value was decreased with decreased differentiation degrees(P<0.050). ② There were statistical differences in the Ktrans and ADC values among the different T stages of rectal cancer(P=0.002;P=0.007), and no statistical differences in the Kep and Ve values(P>0.050) among them. The Ktrans and ADC values were statistically different between the T2 and T3 stages of rectal cancer(P=0.009, P=0.013). ③ The Ktrans and ADC values could distinguish the high and medium differentiation degrees of rectal cancer, its area under ROC curve(AUC) values were 0.677 and 0.763, respectively, and the corresponding best thresholds were 0.180/min and 1.179 mm^2/s;The Ktrans and ADC values could distinguish the medium and low differentiation degrees of rectal cancer, its AUC values w
作者
苟文枭
印隆林
王康
GOU Wenxiao;YIN Longlin;WANG Kang(Department of Radiology,Wenjiang Hospital of Sichuan Provincial People’s Hospital·Chengdu Wenjiang District People’s Hospital,Chengdu 611130,P.R.China;Department of Radiology,Sichuan Provincial People’s Hospital,Chengdu 610072,P.R.China;Department of Gastrointestinal Surgery,Sichuan Provincial People’s Hospital,Chengdu 610072,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第7期884-889,共6页
Chinese Journal of Bases and Clinics In General Surgery
关键词
直肠癌
动态对比增强磁共振成像
定量参数
表观弥散系数
rectal cancer
dynamic contrast-enhanced magnetic resonance imaging
quantitative parameters
apparent diffosion coefficient
