合成MRI联合小视野体素内不相干运动扩散加权成像术前预测直肠癌TN分期的价值  

The value of synthetic MRI combined with reduced field of view intravoxel incoherent motion diffusion weighted imaging in preoperative predicting TN stage of rectal cancer

作　　者：章锦伟 刘啸峰 朱浩雨 汪涛 黄述斌 董江宁 ZHANG Jinwei;LIU Xiaofeng;ZHU Haoyu;WANG Tao;HUANG Shubin;DONG Jiangning(Department of Radiology,Chizhou Hospital Affiliated to Wannan Medical College,Chizhou,Anhui Province 247000,China;Department of Pathology,Chizhou Hospital Affiliated to Wannan Medical College,Chizhou,Anhui Province 247000,China;Department of Radiology,West Branch,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230031,China)

机构地区：[1]皖南医学院附属池州医院影像科,安徽池州247000 [2]皖南医学院附属池州医院病理科,安徽池州247000 [3]中国科学技术大学附属第一医院西区影像科,安徽合肥230031

出　　处：《实用放射学杂志》2025年第1期58-62,共5页Journal of Practical Radiology

基　　金：池州市科技攻关项目(CZ23KJSFy002)。

摘　　要：目的探讨合成MRI联合小视野(rFOV)体素内不相干运动扩散加权成像(IVIM-DWI)术前预测直肠癌TN分期的可行性及其价值。方法收集经手术病理证实的40例直肠癌患者的影像及临床资料,以术后病理分期为金标准,分为低T分期组(T_(1)~T_(2)期)和高T分期组(T3~T4期)及N0期组和N1~N2期组。采用独立样本t检验比较对应的2组间的合成MRI[T_(1)值、T_(2)值、质子密度(PD)值]及IVIM-DWI[真扩散系数(D)值、假扩散系数(D^(*))值、灌注分数(f)值]的参数差异,采用受试者工作特征(ROC)曲线评价有统计学差异的各参数检验效能。结果合成MRI的T_(2)值及IVIM-DWI的D值和f值在直肠癌高、低T分期组间和N0期、N1~N2期组间均有统计学差异(P<0.05)。在预测T分期组时,D值曲线下面积(AUC)最大(AUC=0.888),T_(2)值在N分期组预测中的AUC最大(AUC=0.790),T_(2)值、D值、f值联合模型术前预测直肠癌TN分期的效能最高(AUC=0.890、0.807)。结论合成MRI联合rFOV IVIM-DWI在术前预测直肠癌TN分期是可行的,两者联合预测直肠癌TN分期的效能更高,是常规MRI技术的有益补充。Objective To explore the feasibility and value of synthetic MRI combined with reduced field of view(rFOV)intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)in preoperative predicting TN stage of rectal cancer.Methods The imaging and clinical data of 40 patients with rectal cancer confirmed by operation and pathology were collected and divided into low T stage group(T_(1)-T_(2)stage)and high T stage group(T3-T4 stage),N0 stage group and N1-N2 stage group according to postoperative pathological staging as the golden standard.Independent sample t-tests were conducted to compare the parameter differences of synthetic MRI[T_(1),T_(2),and proton density(PD)values]and IVIM-DWI(D,D^(*),and f values)between the two groups.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of each parameter with statistically significant differences.Results Significant differences were observed in the T_(2)values of synthetic MRI and the D and f values of IVIM-DWI between high and low T stage groups,as well as between N0 and N1-N2 stage groups(P<0.05).The D value showed the highest area under the curve(AUC)(AUC=0.888)in predicting T stage group,and the T_(2)value was predominant(AUC=0.790)for N stage group prediction.The combination models of T_(2),D,and f values yielded superior predictive capability for TN stage in preoperative predicting rectal cancer,with AUC of 0.890 and 0.807,respectively.Conclusion Synthetic MRI combined with rFOV IVIM-DWI is feasible in preoperative prediction of TN stage of rectal cancer,which shows a higher efficacy,and is a useful supplement to conventional MRI technology.

关 键 词：直肠癌 合成磁共振成像 体素内不相干运动扩散加权成像 

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