IVIM全容积定量参数与直肠腺癌神经脉管侵犯、MSI状态及Ki-67指数的相关性研究  

Correlation of full-volume IVIM quantitative parameters with neurovascular invasion,MSI status,and Ki-67 index in rectal adenocarcinoma

作　　者：蒋雯丽 蒋伟[1] 韦鑫 陈媛媛 刘欣杰[1] 陈金华 陈维娟[1] JIANG Wenli;JIANG Wei;WEI Xin;CHEN Yuanyuan;LIU Xinjie;CHEN Jinhua;CHEN Weijuan(Department of Radiology,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院放射科,重庆400010

出　　处：《磁共振成像》2024年第9期80-85,93,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：2022年重庆市科卫联合医学(含中医药类)科研项目(编号:2022MSXM136)。

摘　　要：目的探讨体素内不相干运动(intravoxel incoherent motion,IVIM)全肿瘤容积参数与直肠腺癌患者神经侵犯(perineural invasion,PNI)、脉管侵犯(lymphovascular invasion,LVI)、微卫星不稳定性(microsatellite instability,MSI)状态及Ki-67指数的相关性。材料与方法回顾性分析136例直肠腺癌患者的影像资料和临床资料,测量病灶IVIM全容积参数包括真实扩散系数(D)、伪扩散系数(D*)及灌注分数(f)。根据病理报告中的LVI状态、PNI状态、MSI及Ki-67指数进行分组,采用独立样本t检验或Mann-Whitney U检验分析各定量参数与肿瘤病理学特征的关系。结果直肠腺癌PNI阴性组D值[(1.174±0.164)×10^(-3) mm^(2)/s]显著低于阳性组[(1.270±0.206)×10^(-3) mm^(2)/s](t=-3.033,P=0.003),LVI阴性组f值0.172(0.158,0.193)显著低于阳性组0.188(0.168,0.237)(Z=-2.435,P=0.015),Ki-67低表达组f值(0.175±0.035)显著低于高表达组(0.188±0.038)(t=-2.097,P=0.038),MSI高组和MSI低组的D、D*、f值差异无统计学意义(P>0.05)。结论IVIM全容积定量参数能够在一定程度上反映直肠腺癌的病理学特征,可作为术前评估直肠腺癌生物学行为的重要影像学指标。Objective:To investigate the correlation of intravoxel incoherent motion(IVIM)whole-tumor volume parameter with perineural invasion(PNI),lymphovascular invasion(LVI),microsatellite instability(MSI)status and Ki-67 index in patients with rectal adenocarcinoma.Materials and Methods:Imaging and clinical data of 136 patients with rectal adenocarcinoma were retrospectively analyzed,and the true diffusion coefficient(D),pseudo-diffusion coefficient(D*),and perfusion fraction(f)of the full volume parameter of IVIM of the lesion were measured.The patients were grouped according to pathological reports of PNI status,LVI status,MSI and Ki-67 index,and the relationship between each quantitative parameter and the pathological characteristics of the tumors was analyzed by using independent samples t-test or Mann-Whitney U test.Results:The D value in the PNI-negative group of rectal adenocarcinoma[(1.174±0.164)×10^(-3) mm^(2)/s]was significantly lower than that in the positive group[(1.270±0.206)×10^(-3) mm^(2)/s](t=-3.033,P=0.003),the f value in the LVI-negative group 0.172(0.158,0.193)was significantly lower than that in the positive group 0.188(0.168,0.237)(Z=-2.435,P=0.015),and the f-value of the Ki-67 low expression group(0.175±0.035)was significantly lower than that of the high expression group(0.188±0.038)(t=-2.097,P=0.038).The difference in D,D*,and f values between the high microsatellite instability group and the low microsatellite instability group was not statistically significant(P>0.05).Conclusions:The full volume quantitative parameters of IVIM can reflect the pathological characteristics of rectal adenocarcinoma to a certain extent,and can be used as an important imaging index for preoperative assessment of the biological behavior of rectal adenocarcinoma.

关 键 词：直肠肿瘤 腺癌 磁共振成像 体素内不相干运动 神经侵犯 脉管侵犯 微卫星不稳定性状态 Ki-67 

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]