DWI和T2WI直肠癌体积测量与壁外血管侵犯、淋巴结转移的相关性  

Correlation of DWI and T2WI volume analysis with extramural vascular invasion and lymph node metastasis in rectal cancer

作　　者：张景[1] 靳恒军[1] 张芳[1] 赵伟[1] ZHANG Jing;JIN Heng-jun;ZHANG Fang(Department of Imaging,Huaibei People's Hospital,Anhui 235000,China)

机构地区：[1]淮北市人民医院影像科,安徽235000

出　　处：《放射学实践》2020年第9期1151-1156,共6页Radiologic Practice

基　　金：淮北市2020年市级科技计划项目(2020HK03)。

摘　　要：目的:探讨扩散加权成像(DWI)和T2WI体积分析诊断可切除直肠癌壁外血管侵犯(EMVI)和淋巴结转移(LNM)的效能及其相关性。方法:搜集于术前1周内行MRI检查的直肠癌患者95例,所有患者术后均行病理学检查,术前应用DWI和T2WI进行大体肿瘤体积(GTV)分析,判断两者的诊断效能,并与病理学EMVI和LNM进行相关性分析。结果:DWI和T2WI测量的直肠癌GTV与EMVI(r=0.812 vs r=0.726;P<0.0001)和LNM(r=0.821 vs r=0.761;P<0.0001)相关。单变量分析结果显示DWI和T2WI测量的GTV与EMVI和LNM相关(P值均<0.0001);多变量分析结果显示DWI测量的GTV为EMVI(OR=1.315,P=0.005)和LNM(OR=1.472,P=0.005)的独立危险因素。DWI和T2WI测量的GTV均可用于鉴别LNM N0与N1、N0与N1-N2、N0-N1与N2(P<0.0001);ROC曲线分析结果显示DWI测量的GTV鉴别EMVI(0.901 vs 0.890)、N0与N1(0.871 vs 0.833)、N0与N1-N2(0.931 vs 0.920)、N0-N1与N2(0.928 vs 0.916)的曲线下面积均高于T2WI。结论:可切除直肠癌DWI和T2WI测量的GTV与EMVI、LNM相关,DWI测量的GTV对于EMVI和LNM具有更高的诊断效能。Objective:To investigate the performance and correlation of diffusion weighted imaging(DWI)and T2WI volume analysis in the diagnosis of resectable rectal cancer with extramural vascular invasion(EMVI)and lymph node metastasis(LNM).Methods:A retrospective analysis was performed on 95 patients with rectal cancer who underwent MRI within 1 week before surgery.All patients underwent pathological examination after surgery.Preoperative Gross tumor volume(GTV)analysis was performed using DWI and T2WI to determine the diagnostic performance of both,and its correlation analysis with pathological EMVI and LNM was performed.Results:GTV for rectal cancer measured by DWI and T2WI showed correlations with EMVI(r=0.812 vs r=0.726;P<0.0001)and LNM(r=0.821 vs r=0.761;P<0.0001).GTV measured on DWI and T2WI were associated with EMVI and LNM in univariate analysis(P<0.0001),whereas only the DWI-based value was an independent risk factor for EMVI(OR=1.315;P=0.005)and LNM(OR=1.472,P=0.005)in multivariate analysis.Both values could distinguish between N0 and N1,N0 and N1-N2,and N0-N1 and N2(P<0.0001).The area under the ROC curve was higher for the DWI-based value in EMVI(0.901 vs 0.890),N0 vs N1(0.871 vs 0.833),N0 vs N1-N2(0.931 vs 0.920),and N0-N1 vs N2(0.928 vs 0.916).Conclusion:GTV measured by DWI and T2WI correlate with both EMVI and LNM in resectable rectal cancer.In particular,the DWI-based GTV has higher diagnostic efficacy for EMVI and LNM.

关 键 词：直肠癌 淋巴结转移 壁外血管侵犯 磁共振成像 体积分析 

分 类 号：R735.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]