肿瘤及直肠系膜IVIM参数预测直肠癌同时性肝转移的价值研究  

The value of IVIM parameters in predicting synchronous liver metastasis of rectal cancer in tumor and mesorectal

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作  者:陈婕 陈建有 李振辉 蒋洁智 李志林 艾丛慧 马益 谭静 CHEN Jie;CHEN Jianyou;LI Zhenhui;JIANG Jiezhi;LI Zhilin;AI Conghui;MA Yi;TAN Jing(Department of Radiology,Yunnan Cancer Hospital(The Third Affiliated Hospital of Kunming Medical University),Kunming 650118,China)

机构地区:[1]云南省肿瘤医院(昆明医科大学第三附属医院)放射科,昆明650118

出  处:《磁共振成像》2025年第1期36-41,67,共7页Chinese Journal of Magnetic Resonance Imaging

基  金:云南省科技计划项目基础研究专项(编号:202201AT070010)。

摘  要:目的通过体素内不相干运动(intravoxel incoherent motion,IVIM)研究肿瘤及直肠系膜对直肠癌同时性肝转移(synchronous rectal liver metastasis,SRLM)的预测价值。材料与方法回顾性分析经病理确诊为直肠癌的112例患者资料。其中42例为SRLM,将患者分为SRLM组(n=42)和非SRLM组(n=70)。在肿瘤最大层面勾画3个感兴趣区(region of interest,ROI),分别位于肿瘤、近肿瘤区直肠系膜(ROI距肿瘤<5 mm)和远肿瘤区直肠系膜(ROI距肿瘤>10 mm),测量IVIM参数表观扩散系数(apparent diffusion coefficient,ADC)、纯扩散系数(pure diffusion coefficient,D)、灌注相关扩散系数(pseudo-diffusion coefficient,D*)、灌注分数(perfusion fraction,f)。采用Mann-Whitney U检验和Wilcoxon检验分别比较两组间和各组内参数差异是否有统计学意义,并采用受试者工作特征(receive operating characteristic,ROC)曲线评价组间差异有统计学意义参数的预测效能。结果与非SRLM组相比,SRLM组远肿瘤区ADC、D、f增高(P<0.001),近肿瘤区D、f增高(P<0.05),肿瘤参数差异均无统计学意义(P>0.05)。组内比较后两组远肿瘤区ADC均低于对应近肿瘤区参数和肿瘤参数(P<0.05),D均低于对应近肿瘤区参数和肿瘤参数(P<0.001),但近肿瘤区ADC、D与对应肿瘤参数差异无统计学意义(P>0.05)。远肿瘤区f虽低于近肿瘤区f,但在SRLM组中差异无统计学意义(P>0.05)。远肿瘤区ADC、D、f预测SRLM的曲线下面积(area under the curve,AUC)分别为0.769(95%CI:0.675~0.862)、0.745(95%CI:0.644~0.845)、0.733(95%CI:0.635~0.831)。结论远肿瘤区直肠系膜IVIM参数ADC、f、D,可作为预测发生SRLM的影像学指标,对及时明确SRLM、发现隐匿性和高风险肝转移患者有重要的临床意义。Objective:Through the study of intravoxel incoherent motion(IVIM),this research investigates the predictive value of tumor and mesorectum parameters for synchronous rectal liver metastasis(SRLM)in rectal cancer.Materials and Methods:A retrospective analysis was conducted on data from 112 patients with pathologically confirmed rectal cancer,including 42 patients with SRLM.The patients were divided into the SRLM group(n=42)and the non-SRLM group(n=70).On the maximum cross-sectional image of the tumor,three regions of interest(ROI)were delineated:one in the tumor,one in the near-tumor area(ROI<5 mm from the tumor),and one in the distant-tumor area(ROI>10 mm from the tumor).IVIM parameters apparent diffusion coefficient(ADC),pure diffusion coefficient(D),pseudo-diffusion coefficient(D*),and perfusion fraction(f)were measured The Mann-Whitney U test and the Wilcoxon test were used to compare the statistical significance of parameter differences between and within the groups,respectively.The predictive performance of parameters showing statistically significant differences between groups was evaluated using receiver operating characteristic(ROC)curves.Results:Compared with the non-SRLM group,the SRLM group showed significantly increased parameters ADC,D,and f in the distant tumor area(P<0.001),and increased D and f in the near tumor area(P<0.05).However,the differences in tumor parameters were not statistically significant(P>0.05).After intragroup comparison,the ADC values in the distal tumor regions of both groups were significantly lower than those in the corresponding proximal tumor regions and tumor parameters(P<0.05),and the D values were significantly lower than those in the corresponding proximal tumor regions and tumor parameters(P<0.001).Yet,ADC and D in the near tumor area showed no statistically significant differences compared to the corresponding tumor parameters(P>0.05).Although the parameter f in the distant tumor area was lower than in the near tumor area,this difference was not statistically significan

关 键 词:直肠癌 肝转移 直肠系膜 磁共振成像 体素内不相干运动 预测 

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]

 

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