动态对比增强磁共振成像多定量参数评估早期直肠癌局部浸润和淋巴结转移的研究  

Study on multiple quantitative parameters of DCE-MRI in assessing local invasion and lymph node metastasis of early rectal cancer

作　　者：邢士军[1] 王莉 张永成[1] XING Shi-jun;WANG Li;ZHANG Yong-cheng(不详;Department of Imaging,The Third Affiliated Hospital of Soochow University(The First People's Hospital of Changzhou),Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院)影像科,江苏常州213000

出　　处：《中国医学装备》2022年第9期50-54,共5页China Medical Equipment

基　　金：江苏省卫生健康委2019年度医学科研面上项目(H201957)“根治性切除术前直肠癌3.0T MRI多模态成像的研究”。

摘　　要：目的:评价动态对比增强磁共振成像(DCE-MRI)序列获得多个定量参数对术前评估早期直肠癌局部浸润和淋巴结转移的应用价值。方法:选取医院经病理确诊的100例早期直肠癌患者,美国癌症联合委员会(AJCC)肿瘤临床分期为TNM Ⅰ-Ⅱb期,术前采用MRI平扫和DCE序列成像,获得对比剂容量转换常数(K^(trans))、对比剂回流速率常数(K_(ep))和血管外细胞外容积分数(V_(e))。结果:手术切除病理证实T_(1~2)期56例,T_(3~4)期44例,N_(0)期62例,N_(1)期38例;共检出肠系膜淋巴结289枚,其中良性213枚,恶性76枚。T_(3~4)期患者K^(trans)值明显高于T_(1~2)期,N_(1)期高于N_(0)期,恶性肠系膜淋巴结高于良性,差异有统计学意义(t=16.539,t=24.236,t=18.569;P<0.05)。受试者工作特征(ROC)曲线下面积(AUC)显示,K^(trans)值评估T分期的AUC为0.856,诊断灵敏度和特异度分别为80.5%和72.6%;评估N分期的AUC为0.812,诊断灵敏度和特异度分别为73.6%和70.2%;评估肠系膜淋巴结良恶性的AUC为0.776,诊断灵敏度和特异度分别为70.5%和66.3%。结论:DCE-MRI序列获得定量参数K^(trans)值在术前评估早期直肠癌局部浸润和淋巴结转移中有较好的应用价值。Objective:To evaluate the application value of the obtained multiple quantitative parameters by dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)sequence in preoperative assessment of local invasion and lymph node metastasis of early rectal cancer.Methods:100 patients with early rectal cancer who were confirmed by pathological diagnosis were enrolled in this study.They were staged from tumor node metastasis(TNM)Ⅰ stage to Ⅱ b stage according to the tumor clinical stages of American Joint Committee on Cancer(AJCC).All of them underwent MRI plain scan and DCE sequence imaging,and then,the conversion constant of contrast agent volume(K^(trans)),speed constant of reflux(K_(ep))and extravascular extracellular volume fraction(V_(e))of contrast agent were obtained before operation.Results:The pathological results of surgery verified that 56 cases were at T_(1-2)stage,and 44 cases were at T_(3-4)stage,and 62 cases were at N_(0)stage and 38 cases were at N_(1)stage.As the results,289 mesenteric lymph nodes were found,of which 213 were benign and 76 were malignant.The K^(trans)value of patient at T_(3-4)stage was significantly higher than that at T_(1-2)stage,and the K^(trans)value of patients at N_(1)stage was significantly higher than that at N_(0)stage,and the K^(trans)value of patients with malignant mesenteric lymph node was significantly higher than that with benign mesenteric lymph node(t=16.539,t=24.236,t=18.569,P<0.05).The AUCs of ROC curves indicated that the AUC of K^(trans)value was 0.856 in assessing T stage,the diagnostic sensitivity and specificity of that were 80.5%and 72.6%,respectively.In addition,the AUC of that was 0.812 in assessing N stage,and the diagnostic sensitivity and specificity of that were 73.6%and 70.2%,respectively.Finally,the AUC of that was 0.776 in assessing benign and malignant mesenteric lymph nodes,and the diagnostic sensitivity and specificity of that were 70.5%and 66.3%,respectively.Conclusion:The obtained quantitative parameter K^(trans)value of DCE-MRI sequence has

关 键 词：磁共振动态对比增强扫描(DCE-MRI) 对比剂容量转换常数 直肠癌 淋巴结转移 

分 类 号：R445.2[医药卫生—影像医学与核医学]