| 李娟,高雪梅,程敬亮.T2 mapping评估直肠腺癌预后相关因素[J].中国医学影像技术,2022,38(1):88~92 |
| T2 mapping评估直肠腺癌预后相关因素 |
| T2 mapping for evaluation on prognostic factors for rectal adenocarcinoma |
| 投稿时间：2021-03-08 修订日期：2021-07-24 |
| DOI：10.13929/j.issn.1003-3289.2022.01.021 |
| 中文关键词: 直肠肿瘤 腺癌 磁共振成像 |
| 英文关键词:rectal neoplasms adenocarcinoma magnetic resonance imaging |
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| 中文摘要: |
| 目的 观察T2 mapping评估直肠腺癌预后相关因素的价值。方法 回顾性分析83例经手术病理证实的单发直肠腺癌患者，术前均接受盆腔高分辨T2W、弥散加权成像(DWI)及T2 mapping扫描，比较不同病理分化、T分期、N分期、CRM及EMVI状态肿瘤T2值及表观弥散系数(ADC)的差异。采用受试者工作特性(ROC)曲线，计算曲线下面积(AUC)，分析T2值及ADC评估直肠腺癌预后相关因素的效能。结果 83例中，15例黏液腺癌，68例普通腺癌。68例普通腺癌中，51例中分化腺癌，17例中-低分化腺癌；28例早期(pT1~2期)，40例晚期(pT3~4期)；46例pN0期，22例pN1~2期；15例CRM阳性，53例CRM阴性；12例EMVI阳性，56例EMVI阴性。直肠黏液腺癌的T2值[(184.59±47.79)ms]及ADC[(1.75±0.27)×10-3 mm2/s]均高于普通腺癌[(96.85±17.86)ms、(0.99±0.12)×10-3 mm2/s，t=-3.655、-5.562，P=0.034、0.011]。直肠普通腺癌中，不同N分期病灶的T2值、CRM阴性与阳性病灶间T2值及ADC差异均有统计学意义(P均＜0.05)，其余T2值及ADC差异均无统计学意义(P均＞0.05)。T2值及ADC鉴别直肠黏液腺癌与普通腺癌的AUC分别为0.984及0.994，T2值评估淋巴结转移的AUC为0.806；T2值及ADC评估CRM的AUC分别为0.751及0.647。结论 T2 mapping有助于评估包括病理类型、淋巴结转移及CRM在内的直肠腺癌预后相关因素。 |
| 英文摘要: |
| Objective To explore the value of T2 mapping in evaluation on prognostic factors for rectal adenocarcinoma.Methods A total of 83 patients with rectal adenocarcinoma confirmed by surgical operation pathology who underwent preoperative pelvic MRI, including high-resolution T2WI, diffusion weighted imaging (DWI) and T2 mapping were retrospectively analyzed. T2 values and ADC were compared among different pathological differentiation degrees, T stage, N stage, also between status of circumferential resection margin (CRM) and extramural vascular invasion (EMVI). Receiver operating characteristic (ROC) curve was used, and the corresponding area under the curve (AUC) was calculated to evaluate the diagnostic efficacy of T2 values for evaluation on prognostic factors for rectal adenocarcinoma.Results Among 83 cases of rectal adenocarcinomas (all lesions were single), 15 were mucinous adenocarcinomas and 68 were common adenocarcinomas. For 68 cases of common adenocarcinomas, 51 were moderately differentiated and 17 were moderately-poorly differentiated, 28 were early stage (pT1-2 stage) and 40 were later stage (pT3-4 stage), 46 were pN0 stage and 22 were pN1-2 stage, 15 were positive CRM and 53 were negative CRM, 12 were positive EMVI and 56 were negative EMVI. T2 values (ms) and ADC (×10-3 mm2/s) of rectal mucinous adenocarcinomas were both higher than those of common adenocarcinomas (ms, ×10-3 mm2/s, t=-3.655, -5.562, P=0.034, 0.011). T2 values of different N stages, T2 values and ADC of negative and positive CRM common adenocarcinomas were statistically different (all P < 0.05), while there was no significant difference of T2 values and ADC of rectal common adenocarcinomas with other grouping indexes (all P > 0.05). AUC of T2 values and ADC for distinguishing mucinous adenocarcinomas from common adenocarcinomas was 0.984 and 0.994, respectively, of T2 values in evaluating lymph node metastasis was 0.806, of T2 values and ADC for evaluating CRM was 0.751 and 0.647, respectively.Conclusion T2 mapping was helpful in assessing prognostic factors related to rectal adenocarcinomas, including pathological type, lymph node metastasis and CRM. |
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