高分辨MR成像联合ADC值预测直肠癌新辅助放化疗后区域淋巴结转移的价值  

The Value of High-resolution MR Imaging Combined with ADC Value in Predicting Regional Lymph Node Metastasis in Rectal Cancer after Neoadjuvant Chemoradiotherapy

作　　者：郭成 李常虹 顾华勇 赵希鹏 刘震[1] 王艳丽[1] 刘桂芳 GUO Cheng;LI Chang-Hong;GU Hua-Yong;ZHAO Xi-Peng;LIU Zhen;WANG Yan-Li;LIU Gui-Fang(Molecular Imaging Department of Qingdao University Central Hospital,Qingdao 266042,Shandong Province,China;Radiology Department of Qingdao University Central Hospital,Qingdao 266042,Shandong Province,China)

机构地区：[1]青岛大学附属青岛市中心医院分子影像科,山东青岛266042 [2]青岛大学附属青岛市中心医院放射科,山东青岛266042

出　　处：《中国CT和MRI杂志》2024年第3期155-157,183,共4页Chinese Journal of CT and MRI

摘　　要：目的 探讨高分辨MR成像联合表观扩散系数(ADC)值预测直肠癌新辅助放化疗(nCRT)后区域淋巴结转移的效能。方法纳入青岛大学附属青岛市中心医院2020年5月至2022年5月收治的93局部进展期直肠癌患者为研究对象,于nCRI前、结束时6~8周接受高分辨率MRI T2WI、弥散加权成像检查并在1周内行全直肠系膜切除术。根据术后病理结果分为淋巴结转移组(n=24)和未转移组(n=69)。比较两组nCRT前、后淋巴结短径、长径、ADC值及其变化百分比绝对值(Δ%),分析高分辨MR成像联合ADC值预测直肠癌nCRT后区域淋巴结转移的价值。结果 转移组nCRT前后淋巴结短径均大于非转移组,nCRT前ADC值均小于非转移组(P<0.05);转移组Δ短径%、ΔADC%值均小于非转移组(P<0.05);但两组nCRT前后长径及Δ长径%值比较,差异无统计学意义(P>0.05);经Logistic回归分析显示,Δ短径%、MDC%是直肠癌患者nCRT后区域淋巴结转移的独立预测指标;绘制受试者工作曲线(ROC)显示,Δ短径%、ΔADC%单独及联合预测直肠癌患者nCRT后区域淋巴结转移的曲线下面积(AUC)分别为0.748、0.852、0.879,具有一定预测价值。结论 高分辨MR成像联合ADC值预测直肠癌nCRT后区域淋巴结转移具有一定的价值,其中淋巴结短径与ADC值变化可有效提示nCRT后区域淋巴结转移情况。Objective To investigate the efficacy of high-resolution MR imaging combined with apparent diffusion coefficient(ADC)values in predicting regional lymph node metastasis in rectal cancer after neoadjuvant chemoradiotherapy(nCRT).Methods 93 locally advanced rectal cancer patients admitted to the hospital from May 2020 to May 2022 were included as the study subjects.High-resolution MRI T2WI and diffusion-weighted imaging were performed before and at 6-8 weeks after nCRT,and total mesorectal resection was performed within 1 week.According to postoperative pathological results,they were divided into lymph node metastasis group(n=24)and non metastasis group(n=69).The absolute values of short diameter,long diameter,ADC values and their percentage changes(Δ%)of lymph nodes before and after nCRT in two groups were compared,and the value of high-resolution MR imaging combined with ADC values in predicting regional lymph node metastasis in rectal cancer after nCRT was analyzed.Results The short diameter of lymph nodes before and after nCRT in the metastasis group was greater than that in the non metastasis group,and the ADC value before nCRT was lower than that in the non metastasis group(P<0.05).TheΔshort diameter%andΔADC%values in the metastasis group were lower than those in the non metastasis group(P<0.05).However,there was no statistical significant difference in the percentage values of length diameter andΔlength diameter%before and after nCRT between the two groups(P>0.05).Logistic regression analysis showed thatΔshort diameter%andΔADC%were independent predictive indicators of regional lymph node metastasis in rectal cancer patients after nCRT.The receiver operating curve(ROC)showed that the area under the curve(AUC)ofΔshort diameter%,ΔADC%alone and combined in predicting regional lymph node metastasis after nCRT in rectal cancer patients was 0.748,0.852 and 0.879,respectively,which had certain predictive value.Conclusion The combination of high-resolution MR imaging and ADC value has certain value in predict

关 键 词：直肠癌 新辅助放化疗 区域淋巴结转移 高分辨MR成像 表观扩散系数值 

分 类 号：R735.37[医药卫生—肿瘤]