多层螺旋CT增强联合动态增强磁共振功能成像评价结直肠癌术后局部复发/转移的临床价值  

Clinical Value of Multi-slice Spiral CT Enhancement Combined with Dynamic Contrast-enhanced Magnetic Resonance Functional Imaging in Evaluating Postoperative Local Recurrence/Metastasis of Colorectal Cancer

作　　者：徐佳 程小杰 Xu Jia;Cheng Xiao-jie(The Third People's Hospital of Hubei Province,Wuhan 430000,Hubei Province,China;Wuhan Sixth Hospital,Wuhan 430000,Hubei Province,China)

机构地区：[1]湖北省第三人民医院,湖北武汉430000 [2]武汉市第六医院,湖北武汉430000

出　　处：《中国CT和MRI杂志》2024年第7期160-162,共3页Chinese Journal of CT and MRI

基　　金：武汉市卫生健康委科研项目(NO.WX21C26)。

摘　　要：目的探究多层螺旋CT增强联合动态增强磁共振功能成像评价结直肠癌(CRC)术后局部复发/转移的临床价值。方法选取2019年10月至2021年10月期间本院收治的82例CRC患者,根据患者术后情况分为复发或转移组(36例)和未复发或转移组(46例);所有患者均进行多层螺旋CT增强和动态增强磁共振功能成像检查;绘制ROC曲线分析多层螺旋CT增强及转运常数(K^(trans))、反流速率常数(K_(ep))和血管外细胞外容积分数(V_(e))对CRC术后局部复发/转移的诊断价值;采用四格表分析多层螺旋CT增强联合动态增强磁共振功能成像评价CRC术后局部复发/转移的诊断价值。结果多层螺旋CT增强扫描检查的39例阳性患者中出现复发或转移有30例,未复发或转移的有9例,检查的43例阴性患者中出现复发或转移的有6例,未复发或转移的有37例。复发或转移组K^(trans)、K_(ep)和V_(e)均显著高于未复发或转移组(P<0.05)。根据ROC曲线得知,K^(trans)诊断CRC术后局部复发/转移的曲线下面积(AUC)为0.846,K_(ep)诊断CRC术后局部复发/转移的AUC为0.780,V_(e)诊断CRC术后局部复发/转移的AUC为0.861,多层螺旋CT增强诊断CRC术后局部复发/转移的AUC为0.819,四者联合诊断CRC术后局部复发/转移的AUC为0.987。多层螺旋CT增强在CRC术后局部复发/转移诊断中准确度为81.71%;动态增强磁共振功能成像在CRC术后局部复发/转移诊断中准确度为85.37%;二者联合检测在CRC术后局部复发/转移诊断中准确度为93.90%。结论多层螺旋CT增强联合动态增强磁共振功能成像能显著提高CRC术后局部复发/转移诊断效能,对于患者在术后随访监测有较高的临床价值。Objective To investigate the clinical value of multislice spiral CT enhancement combined with dynamic enhanced magnetic resonance functional imaging for the evaluation of local recurrence/metastasis after colorectal cancer(CRC)surgery.Methods Eighty-two CRC patients admitted to our hospital between October 2019 and October 2021 were selected and divided into the recurrence or metastasis group(36 patients)and the non-recurrence or metastasis group(46 patients)according to their postoperative conditions;all patients underwent multilayer spiral CT-enhanced and dynamicallyenhanced magnetic resonance functional imaging;ROC curves were plotted to analyse the diagnostic value of multilayer spiral CT-enhanced and transport constant(K^(trans)),reflux rate constant(K_(ep)),and extracellular volume fraction(V_(e))on the diagnostic value of local recurrence/metastasis after CRC;a four-cell table was used to analyse the diagnostic value of multilayer spiral CT enhancement combined with dynamic enhanced magnetic resonance functional imaging to evaluate the diagnostic value of local recurrence/metastasis after CRC.Results Multi-slice spiral CT enhanced scanning showed that among the 39 positive patients examined,30 had recurrence or metastasis,9 had no recurrence or metastasis,and among the 43 negative patients examined,6 had recurrence or metastasis,and 37 had no recurrence or metastasis.The K^(trans),K_(ep),and V_(e) levels in the recurrent or metastatic group were obviously higher than those in the non recurrent or metastatic group(P<0.05).According to the ROC curve,the area under the curve(AUC)of K^(trans) to diagnose local recurrence/metastasis of CRC after surgery was 0.846,the AUC of K_(ep) to diagnose local recurrence/metastasis of CRC after surgery was 0.780,the AUC of V_(e) to diagnose local recurrence/metastasis of CRC after surgery was 0.861,the AUC of multi-slice spiral CT enhanced diagnosis for postoperative local recurrence/metastasis of CRC was 0.819,the AUC for the combined diagnosis of local recurrence/metasta

关 键 词：多层螺旋CT增强 动态增强磁共振功能成像 结直肠癌 复发 转移 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.37[医药卫生—诊断学]