动态增强磁共振成像在直肠癌术前诊断中的应用研究  

Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging in the Preoperative Diagnosis of Rectal Cancer

作　　者：沈浮[1] 陆建平[1] 陈录广[1] 王振[1] 陈玉坤[1] 

机构地区：[1]第二军医大学附属长海医院放射科

出　　处：《中国医学计算机成像杂志》2016年第1期39-43,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨直肠癌的动态增强磁共振成像(DCE-MRI)表现及其参数对直肠癌术前诊断的意义。方法:30例经病理证实的直肠癌患者术前进行DCE-MRI成像,应用Tofts模型后处理分析得到感兴趣区的微循环参数Ktrans、Kep、Ve和i AUC值,与术后病理分期及分化程度进行Kruskal-Wallis秩和检验和Spearman秩相关性分析。结果:30例直肠癌中,术后病理p T1 6例,p T2 15例,p T3 9例;低分化腺癌3例,中分化腺癌21例,高分化腺癌6例。直肠癌病灶的时间-信号强度曲线表现为流出型。Ktrans均值为0.257±0.166,Kep均值为0.585±0.039,i AUC均值为35.092±1.681,Ve均值0.489±0.020。不同T分期组间Ktrans值、Kep值、i AUC值差异有统计学意义(P均<0.05),且与T分期有正相关性(P均<0.05);不同分化程度组间Ktrans值、Kep值、i AUC值差异有统计学意义(P均<0.05);i AUC值与病理分化程度有正相关性(P<0.05)。结论:磁共振动态增强成像能反映直肠癌的微循环差异,对直肠癌的术前分期及分化程度的评估具有一定的价值。Purpose： To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） in evaluation of rectal cancer,to explore the characteristics of the DCE-MRI parameters. Methods：Thirty patients with histologically proven rectal cancer were studied by preoperative DCE-MRI. All of the data were transferred to the workstation, and the microcirculation parameters of region of interest were analyzed by using the Tofts model, which included Ktrans, Kep, Ve, i AUC. The correlation between the parameters and the postoperative pathology results were statistically analyzed. Results： The postoperative pathological results showed that 6 cases were p T1, 15 cases were p T2, 9 cases were p T3;3 cases of tumors were low differentiated, 21 cases were middle differentiated, 6 cases were high differentiated. The time-signal intensity curve was washout type. The mean Ktrans values was 0.257±0.166,mean Kep values was 0.585±0.039,mean i AUC values was 35.092±1.681,mean Ve values was 0.489±0.020. Ktrans, Kep, i AUC and T stage were positive correlated, P〈0.05. i AUC was positive correlated with the degree of pathological differentiation, P〈0.05. Conclusion： The parameters of DCE-MRI can reflect the blood supply of the rectal cancer, they have certain effect on preoperative evaluation of the staging and differentiation degree.

关 键 词：直肠癌 磁共振成像 动态增强磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]