| 柴亚欣,牛永超.动态对比增强MRI联合体素内不相干运动术前评估直肠癌病理分型[J].中国医学影像技术,2023,39(12):1833~1837 |
| 动态对比增强MRI联合体素内不相干运动术前评估直肠癌病理分型 |
| Dynamic contrast enhanced MRI combined with intravoxel incoherent motion for preoperative evaluation on pathological type of rectal cancer |
| 投稿时间：2023-08-16 修订日期：2023-10-17 |
| DOI：10.13929/j.issn.1003-3289.2023.12.021 |
| 中文关键词: 直肠肿瘤 腺癌 体素内不相干运动 磁共振成像 |
| 英文关键词:rectal neoplasms adenocarcinoma intravoxel incoherent motion magnetic resonance imaging |
| 基金项目:河南省医学科技攻关计划联合共建项目（LHGJ20210902）、医学与健康事业研究发展基金项目一河南省伦琴影像科研专项（HN-20201017-007）。 |
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| 中文摘要: |
| 目的 观察动态对比增强MRI （DCE-MRI）联合体素内不相干运动（IVIM）术前评估直肠癌病理类型的价值。方法 纳入81例直肠腺癌患者，根据术后病理结果分为黏液腺癌组（n=36）和非黏液腺癌组（n=45）；比较组间DCE-MRI参数及IVIM参数，包括速率常数（Kep）、容积转运常数（Ktrans）、血管外细胞外间隙容积分数（Ve），以及真弥散系数（D）、假弥散系数（D*）、灌注分数（f）；行logistic回归分析，观察上述参数术前诊断直肠癌病理分型的效能。结果 黏液腺癌组Kep、Ktrans、D*和f均小于非黏液腺癌组（P均<0.05）；其中，Kep和f为直肠癌病理分型的影响因素（P均<0.05）。术前以Kep、f及二者联合评估直肠癌病理分型的曲线下面积（AUC）分别为0.774、0.880和0.906，敏感度为69.44%、77.78%和86.11%，特异度为82.22%、91.11%和91.11%；二者联合的AUC高于Kep（P<0.05）。结论 DCE-MRI联合IVIM可于术前评估直肠癌病理类型。 |
| 英文摘要: |
| Objective To observe the value of dynamic contrast enhanced MRI (DCE-MRI) combined with intravoxel incoherent motion (IVIM) for preoperative evaluation on pathological type of rectal cancer. Methods Totally 81 patients with rectal adenocarcinoma were enrolled and divided into mucinous adenocarcinoma group (n=36) or non mucinous adenocarcinoma group (n=45) based on postoperative pathological results. Parameters of DCE-MRI and IVIM, including rate constant (Kep), volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), true diffusion coefficient (D), pseudo diffusion coefficient (D*) and perfusion fraction (f) were compared between groups. Logistic regression analysis was performed, the efficacy of the above parameters for evaluation on pathological type of rectal cancer were explored. Results Kep, Ktrans, D* and f of mucinous adenocarcinoma group were all smaller than those of non mucinous adenocarcinoma group (all P<0.05). Kep and f were both impact factors of pathological type of rectal cancer (both P<0.05). The area under the curve (AUC) of Kep, f and Kep+f for preoperative evaluation on pathological type of rectal cancer was 0.774, 0.880 and 0.906, respectively, with sensitivity of 69.44%, 77.78% and 86.11%, specificity of 82.22%, 91.11% and 91.11%, respectively. AUC of Kep was lower than that of Kep+f (P<0.05). Conclusion DCE-MRI combined with IVIM could effectively evaluate the pathological type of rectal cancer preoperation. |
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