摘要
目的探讨多期动态增强磁共振成像检查(DCE-MRI)直方图预测结直肠癌手术治疗患者预后的价值。方法采用回顾性队列研究方法。收集2018年1月至2019年2月酒泉市人民医院收治的81例结直肠癌患者的临床病理资料;男47例,女34例;年龄(62±6)岁。患者均行常规MRI及DCE-MRI扫描,提取相关影像学参数。观察指标:(1)治疗与影像学检查及随访结果。(2)影响结直肠癌患者术后无疾病生存的影像学因素分析。正态分布的计量资料以x±s表示,偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。单因素和多因素分析均采用COX比例风险模型。Pearson相关性检验分析并排除具有相关性的单因素参数,其余参数再行多因素分析。采用Kaplan-Meier法计算生存率,采用Log-Rank检验进行生存分析。结果(1)治疗与影像学检查及随访结果。81例患者术前均行MRI平扫+增强+弥散加权成像检查,完善检查后均行结直肠癌根治性切除术,术后均采用FOLFOX方案进行化疗。术后81例患者均获得随访,随访时间为42(11~61)个月。81例患者术后1、3、5年总生存率分别为98.8%、96.3%、93.8%。81例患者随访期间,56例无疾病生存,25例疾病进展。(2)影响结直肠癌患者术后无疾病生存的影像学因素分析。多因素分析结果显示:正性增强积分(PEI)峰度值和偏度值是影响结直肠癌患者术后无疾病生存的独立影像学因素(优势比=1.840,1.243,95%可信区间为1.403~2.412,1.020~1.516,P<0.05)。进一步分析:取PEI峰度值和偏度值的中位数分别为4.864和5.042,PEI峰度值<4.864和PEI峰度值≥4.864患者术后5年无疾病生存率分别为89.7%和10.3%,两者生存情况比较,差异有统计学意义(χ^(2)=31.265,P<0.05);PEI偏度值<5.042和PEI偏度值≥5.042患者术后5年无疾病生存率分别为63.4%和36.6%,两者生存情况比较,差异有统计学意义(χ^(2)=8.164,P<0.05)。结论DCE-MRI检查直方图PEI峰度值和�
Objective To investigate the value of multi-stage dynamic contrast enhanced MRI(DCE-MRI)histogram in predicting survival of patients undergoing surgical treatment of colorectal cancer(CRC).Methods The retrospective cohort study was conducted.The clinico-pathological data of 81 patients with CRC who were admitted to the Jiuquan City People′s Hospital from January 2018 to February 2019 were collected.There were 47 males and 34 females,aged(62±6)years.All patients underwent routine MRI and DCE-MRI examination to extract relevant imaging parameters.Observation indicators:(1)treatment,imaging examination and follow-up;(2)imaging factors influencing postoperative disease-free survival of patients with CRC.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers.Univariate and multivariate analyses were conducted using the COX proportional risk model.Pearson correlation test was used to analyze and exclude factors with correlation in univariate analysis,and the multi-variate analysis was conducted on the rest of factors.The Kaplan-Meier method was used to calculate survival rates,and Log-Rank test was used for survival analysis.Results(1)Treatment,imaging examination and follow-up.All 81 patients underwent preoperative MRI plain scan,enhanced imaging,and diffusion weighted imaging.After complete examination,all patients underwent radical resection of CRC and received postoperative chemotherapy using the FOLFOX regimen.All 81 patients were followed up for 42(range,11-61)months after surgery.The 1-,3-,5-year overall survival rate of 81 patients after surgery was 98.8%,96.3%,93.8%,respectively.During the follow-up period,56 of the 81 patients survived from disease-free and 25 patients had disease progressed.(2)Imaging factors influencing postoperative disease-free survival of patients with CRC.Results of multivariate analysis showed that the kurtosis value and skewness value of positive
作者
胡建军
史新龙
何毅
王建明
王光辉
王保刚
Hu Jianjun;Shi Xinlong;He Yi;Wang Jianming;Wang Guanghui;Wang Baogang(Department of Anorectal Surgery,Jiuquan City People′s Hospital,Jiuquan 735099,China;Department of Anorectal Surgery,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Radiology,Jiuquan City People′s Hospital,Jiuquan 735099,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2023年第8期1028-1033,共6页
Chinese Journal of Digestive Surgery
基金
甘肃省自然科学基金(21JR7RA624)。
关键词
结肠肿瘤
直肠肿瘤
磁共振成像
多期动态增强
直方图
生存预测
Colonic neoplasms
Rectal neoplasms
Magnetic resonance imaging
Multi-stage dynamic contrast enhancement
Histogram
Survival prediction
