IVIM及DCE-MRI在直肠腺癌病理分级和淋巴结转移中的应用

Application of IVIM with DCE-MRI in Pathological Grade and Lymph Node Metastasis of Rectal Adenocarcinoma

目的探讨体素内不相干运动(IVIM)及动态对比增强磁共振成像(DCE-MRI)在直肠腺癌病理分级和淋巴结转移中的应用价值。方法收集81例直肠腺癌患者,低分化组(28例)、中分化组(32例)、高分化组(21例),37例淋巴结被分为转移组(20例)和非转移组(17例)。不同病理分级组或淋巴结组间参数值差异采用单因素方差分析或者Kruskal-Wallis H分析、独立样本t检验或者Mann-Whitney U检验,诊断效能用受试者工作特征曲线(ROC)比较。结果在不同病理分级组中,Kep、D*值均存在统计学差异(P<0.05)。Kep值、f值及D值在淋巴结转移组和非转移组间存在统计学差异(P<0.05)。Kep值及D值纳入Logistic回归方程,获得联合预测概率P值。Kep值、D值及联合预测概率P值的AUC分别为0.885、0.819、0.924。结论IVIM联合DCE-MRI可以辅助诊断直肠腺癌的病理分级和淋巴结转移与否,两者联合可以提高诊断效能。

Objective To explore the application value of intravoxel incoherent motion(IVIM)with dynamic contrastenhanced magnetic resonance imaging(DCE-MRI)in pathological grade and lymph node metastasis of rectal adenocarcinoma.Methods The 81 patients with rectal adenocarcinoma were collected.Poorly differentiated group(28cases),moderately differentiated group(32cases)and highly differentiated group(21 cases).37 cases of lymph nodes were divided into metastatic group(20 cases)and non-metastatic group(17cases).The difference of parameter values between different pathological grading groups or lymph node groups were analyzed by one-way ANOVA or Kruskal-Wallis H analysis,independent sample t-test or Mann-Whitney U test.Diagnostic effectiveness was compared by receiver operating characteristic(ROC)curve.Results In different pathological grade groups,Kepand D*values showed statistical differences(P<0.05).Kep,f and D values showed statistical differences between the lymph node metastasis group and the non-metastasis group(P<0.05).Kep value and D value were included in Logistic regression equation,and the joint prediction probability P value was obtained.The AUC of Kep value,D value and joint prediction probability P value were 0.885,0.819 and 0.924 respectively.Conclusion IVIM combined with DCE-MRI can assist in the diagnosis of pathological grade and lymph node metastasis of rectal adenocarcinoma,and the combination of the two can improve the diagnostic efficiency.