直肠癌DCE-MRI参数与病理分期的相关性研究

Relationship between DCE-MRI parameters and pathological staging in rectal cancer

目的探讨3.0T DCE-MRI参数与直肠癌病理分期的相关性,为临床提高直肠癌术前诊断提供参考。方法收集本院2015年3月至2016年4月符合条件的直肠癌患者68例,通过3.0T DCE-MRI及处理工作站测量容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙体积百分比值(Ve)并绘制时间-信号强度曲线,比较直肠癌不同病理分期的Ktrans、Kep、Ve值及其相关性。结果在直肠癌不同病理T分期中,肿瘤Ktrans值差异有统计学意义(P<0.05),而Kep及Ve值差异无统计学意义(P>0.05)。在直肠癌不同病理N分期中,肿瘤Ktrans值、Kep值、Ve值差异均无统计学意义(P>0.05)。当肿瘤Ktrans值等于0.869 min-1为判断直肠癌病理T分期(早/晚期)诊断阈值时,其诊断灵敏度为59.0%,特异度为99.0%。直肠癌病理T分期与Ktrans值呈正相关(r=0.403,P<0.01)。结论直肠癌T分期与肿瘤Ktrans值呈正相关,DCE-MRI参数可为直肠癌术前诊断提供一定参考。

Objective To investigate the correlation between 3.0 T DCE-MRI parameters and pathological stage of rectal cancer,and to provide more valuable information for clinical improvement of preoperative diagnosis and prognosis of rectal cancer. Methods A total of 68 patients with rectal cancer were enrolled at our hospital from March 2015 to April 2016.The volume transfer constant（Ktrans）,rate constant（Kep）,and extravascular extracellular volume fraction（Ve）were measured,and time-signal intensity curves were plotted from the 3.0 T MRI and processing station. The Ktrans,Kep,Ve values of different pathological stages of rectal cancer were com-pared,and potential correlations were explored. Results Ktransdiffered significantly among pathological T stages（P〈0.05）,but Kep and Ve did not（P〉0.05）.Ktrans,Kep and Ve did not differ significantly among different stages of rectal cancer（P〉0.05）. The diagnostic threshold of the tumor Ktransvalue was 0.869 min-1,which served as an indicator to determine whether T stage was early or late. Diagnostic sensitivity was 59.0% and specificity was 99.0%. The pathological T stage of rectal cancer showed a positive correlation with tumor Ktrans（r=0.403,P〈0.01）. Conclusions The T stage of rectal cancer positively correlated with tumor Ktrans. These DCE-MRI parameters can provide a meaningful reference value for preoperative diagnosis and clinical prognosis of rectal cancer.