动态增强磁共振成像定量灌注参数在直肠癌患者术前分期中的应用价值

Application value of quantitative perfusion parameters of dynamic enhanced magnetic resonance imaging in preoperative staging evaluation of rectal cancer patients

目的:探讨动态增强磁共振成像(DCE-MRI)定量灌注参数在直肠癌患者术前分期中的应用价值。方法:选取2019年1月至2020年12月该院收治的80例直肠癌患者进行前瞻性研究,患者入院后均行DCE-MRI检查,获取相关定量灌注参数判断患者分期,以病理学检查结果为金标准,比较不同分期直肠癌患者DCE-MRI定量灌注参数[容量转移常数(K_(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_(e))]水平,采用受试者工作特征(ROC)曲线分析DCE-MRI定量灌注参数在直肠癌患者术前分期中的应用价值。结果:病理学检查结果显示,80例直肠癌患者中,Ⅰ~Ⅱ期36例(45.00%),Ⅲ~Ⅳ期44例(55.00%);Ⅲ~Ⅳ期患者K_(trans)、V_(e)值均高于Ⅰ~Ⅱ期者,差异有统计学意义(P<0.05);Ⅲ~Ⅳ期与Ⅰ~Ⅱ期患者K_(ep)值比较,差异无统计学意义(P>0.05);ROC曲线分析结果显示,K_(trans)、V_(e)单项及联合评估直肠癌患者术前分期为Ⅲ~Ⅳ期的曲线下面积(AUC)均>0.70,且K_(trans)、V_(e)联合评估的AUC大于单项评估。结论:DCE-MRI定量灌注参数在直肠癌患者术前分期评估中具有一定应用价值,且K_(trans)、V_(e)联合评估的应用价值最高。

Objective:To explore application value of quantitative perfusion parameters of dynamic enhanced magnetic resonance(DCEMRI)imaging in preoperative staging evaluation of rectal cancer patients.Methods:A prospective study was conducted on 80 patients with rectal cancer admitted to the hospital from January 2019 to December 2020.All patients underwent DCE-MRI examination after admission,and the relevant quantitative perfusion parameters were obtained to determine the stage of these patients.By using the results of pathological examination as the gold standard,the quantitative perfusion parameter levels[volume transfer constant(K_(trans)),rate constant(K_(ep)),volume fraction of extravascular extracellular space(V_(e))]of DCE-MRI in the patients with different stages of rectal cancer were compared.The value of DCE-MRI quantitative perfusion parameters in the preoperative staging of rectal cancer was analyzed.Results:The pathological examination showed that among the 80 patients with rectal cancer,36 cases were in stage Ⅰ~Ⅱ,accounting for 45.00%(36/80),and 44 cases were in stage Ⅲ~Ⅳ,accounting for 55.00%(44/80).The K_(trans) and V_(e) values of the patients with stage Ⅲ~Ⅳ were higher than those with stage Ⅰ~Ⅱ,and the differences were statistically significant(P<0.05).There was no significant difference in the K_(ep) value among the patients with stage Ⅲ~Ⅳ and the patients with stage Ⅰ~Ⅱ(P>0.05).The AUC of single K_(trans),single V_(e) and the combined evaluation for the rectal cancer patients with preoperative stage Ⅲ~Ⅳ were all>0.70,and the value of combined evaluation was the highest.Conclusions:DCE-MRI quantitative perfusion parameters have certain application value in the preoperative staging evaluation of the rectal cancer patients,and the value of combined evaluation is the highest.