DCE-MRI和IVIM-DWI评估直肠癌微血管含量的比较研究  

A comparative study of DCE-MRI and IVIM-DWI in evaluating microvascular content in rectal cancer

作　　者：袁杰[1] 朱璟 叶恺[1] 吴宏勇 沈嫱 丘兆臻 王子元[2] 刘孟潇 姚明荣[1] YUAN Jie;ZHU Jing;YE Kai;WU Hongyong;SHEN Qiang;QIU Zhaozhen;WANG Ziyuan;LIU Mengxiao;YAO Mingrong(Department of Radiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Departments of Pathology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Siemens Healthineers Ltd,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院影像医学科,上海201203 [2]上海中医药大学附属曙光医院病理科,上海201203 [3]西门子医疗系统有限公司,上海200120

出　　处：《肿瘤影像学》2024年第3期301-306,共6页Oncoradiology

基　　金：国家自然科学基金青年基金(81703885);国家自然科学基金面上基金(82374188)。

摘　　要：目的:探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)和体素内不相干运动弥散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)在评估直肠癌微血管含量中的差异。方法:研究2019年12月—2022年12月上海中医药大学附属曙光医院经病理学检查诊断为直肠腺癌并行IVIMDWI和DCE-MRI扫描的患者23例。Tofts模型计算DCE-MRI参数为容积分数(volume fraction,V_(e))、容量转移常数(space transport coefficient,K^(trans))和速率常数(rate constant,K_(ep))。IVIM-DWI参数:单纯弥散系数(simple diffusion coefficient,D),灌注相关弥散系数(perfusion related diffusion coefficient,D^(*)),灌注分数(perfusion fraction,f),通过计算双指数模型得到。对与直肠癌微血管含量相关的DCE-MRI和IVIM-DWI定量参数进行分析比较。结果:不同病理学分级的直肠癌K^(trans)和D差异有统计学意义(F=9.159,P=0.002;F=5.106,P=0.016)。在评估直肠癌病理学分级时,K^(trans)优于D。灌注参数K^(trans),K_(ep)和D^(*)与直肠癌微血管含量呈显著正相关(r=0.734,P<0.001;r=0.617,P=0.002;r=0.456,P=0.029)。其中DCE-MRI定量参数评估直肠癌微血管含量优于IVIM-DWI定量参数。结论:与IVIM-DWI相比,DCE-MRI评价直肠癌分化程度和微循状态方面效能更佳。但是考虑到IVIM-DWI不需要注射对比剂,IVIM-DWI仍然可以被推荐用于直肠癌分化程度和微循环状态。Objective:To compare dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)with intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in evaluating microvascular content in rectal cancer.Methods:This study was conducted on 23 patients with rectal adenocarcinoma confirmed by preoperative endoscopic pathology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from December 2019 to December 2022.All subjects underwent IVIM-DWI and DCE-MRI scans before surgery.The DCE-MRI parameters calculated by the Tofts model were extracellular space volume fraction(V_(e)),space transport coefficient(K^(trans)),and rate constant of extracellular space return to intravascular space(K_(ep)).The IVIM-DWI parameters were calculated by the double exponential model:simple diffusion coefficient(D),perfusion related diffusion coefficient(D^(*)),and perfusion fraction(f).The correlation between DCE-MRI and IVIM-DWI quantitative parameters and microvascular content in rectal cancer was analyzed and compared.Results:There were significant differences in K^(trans) and D values of colorectal cancer in different pathological grades(F=9.159,P=0.002;F=5.106,P=0.016).K^(trans) was superior to the D value in evaluating rectal cancer grading.K^(trans),K_(ep) and D^(*)were positively correlated with microvascular content in rectal cancer(r=0.734,P=0.000;r=0.617,P=0.002;r=0.456,P=0.029).DCE-MRI quantitative parameters were superior to IVIM-DWI quantitative parameters in evaluating microvascular content in rectal cancer.Conclusion:DCE-MRI was superior to IVIM-DWI in evaluating the differentiation degree and microcycle status of rectal cancer.However,considering that IVIM-DWI does not require injection of contrast agents,IVIM-DWI can still be recommended for the microcirculation of rectal cancer.

关 键 词：直肠癌 动态对比增强磁共振成像 体素内不相干运动弥散加权成像 微血管 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]