DCE-MRI定量参数与直肠癌病理分期及分级的相关性研究

Dynamic Contrast Enhanced MRI of Rectal Cancer:a Study of the Correlations Between Quantitative Parameters and Pathological Stage and Grades

目的探讨动态增强磁共振成像(DCE-MRI)定量参数与直肠癌T分期、淋巴结转移及肿瘤分化程度的相关性。方法连续搜集本院2012年12月21日至2015年8月3日符合纳入标准的原发直肠癌患者91例,术前行常规MRI及DCE-MRI扫描,测量DCE-MRI定量参数[转运常数(K^(trans))、速率常数(K_(ep))、容积分数(V_e)值],并分析与直肠癌T分期、淋巴结转移、肿瘤分化程度的关系。结果 K^(trans)、K_(ep)、V_e与直肠癌T分期存在正相关(r=0.758,P=0.000;r=0.395,P=0.000;r=0.314,P=0.002);K^(trans)及K_(ep)在有无转移淋巴结组之间比较有显著性差异(t=6.893,P=0.000;t=3.355,P=0.001);K^(trans)、V_e与肿瘤分化程度存在负相关(r=-0.223,P=0.034;r=-0.259,P=0.013)。结论 DCE-MRI药代动力学定量参数与直肠癌T分期及淋巴结转移、肿瘤分化程度存在一定的相关性,定量参数可以为直肠癌的临床预后提供一定的参考价值。

Objective To analyze the correlation between quantitative parameters of dynamic contrast enhanced MRI and pathological stage and grades,including T stage,lymph nodes involvement and histological differentiation grades.Methods Ninety-one patients with rectal cancer who were diagnosed in our hospital between December 21,2012 to August 3,2015 were included in our study. Routine MRI and dynamic contrast enhanced MRI was performed before surgery.Mean tumor K^（trans）,K_（ep）,V_e values were measured,then to analyze the correlation of K^（trans）,K_（ep）,V_e values with T stage lymph nodes involvementand histological differentiation grades in rectal cancer. Results There was a positive correlation between K^（trans）,K_（ep）,V_e and T stage（ r = 0. 758,P = 0. 000; r = 0. 395,P = 0. 000; r = 0. 314,P = 0. 002）. The K^（trans）and K_（ep）values were significant different between lymph nodes involved group with noninvolved group（ t = 6. 893,P = 0. 000; t =3. 355,P = 0. 001）. There was negative correlation between K^（trans）,V_e and histological differentiation grades（ r =- 0. 223,P= 0. 034; r =- 0. 259,P = 0. 013）. Conclusion The certain correlations were found between quantitative parameters of dynamic contrast enhanced MRI and T stage,the lymph nodes involvement and histological differentiation grades. This can provide some reference information for prognosis of rectal cancer.