不同分化程度直肠癌磁共振成像ADC值与DCE-MRI定量参数的相关性

目的探讨不同分化程度直肠癌诊断中表观扩散系数(apparent diffusion coefficient,ADC)值与磁共振动态增强扫描成像(dynamic contrast enhanced MRI,DCE-MRI)定量参数间的相关性。材料与方法对102例病理学证实为直肠腺癌的患者根据肿瘤分化程度分为高分化组(n=23)、中分化组(n=59)、低分化组(n=20)。对不同组弥散加权成像(diffusion weighted imaging,DWI)、DCE-MRI图像回顾性分析,测量其ADC_(mean)值及K~(trans)、V_e、K_(ep)值,分析不同组内ADC_(mean)值与K~(trans)、V_e、K_(ep)值的相关性。结果高分化组ADC_(mean)、K~(trans)、V_e、K_(ep)值分别为:(1.13±0.25)mm~2/s、(0.28±0.09)min~(-1)、(0.46±0.15)、(0.67±0.18)min~(-1);中分化组ADC_(mean)、K~(trans)、V_e、K_(ep)值依次为(0.94±0.05)mm~2/s、(0.28±0.09)min~(-1)、(0.52±0.24)、(0.63±0.25)min~(-1);低分化组ADC_(mean)、K~(trans)、V_e、K_(ep)值分别为(0.79±0.07)mm~2/s、(0.40±0.08)min~(-1)、(0.67±0.16)、(0.66±0.15)min~(-1),各组间K_(ep)及高、中分化组间K~(trans)、V_e差异无统计学意义(P0.05),其余有统计学意义(P0.05)。直肠癌中、低分化组ADC_(mean)与K~(trans)值呈负相关(r中=-0.34,r低=-0.60,P0.05)。不同分化组ADC_(mean)与V_e、K_(ep)值Pearson相关性,差异无统计学意义(P0.05)。随着直肠癌分化程度的升高ADC_(mean)值升高,K~(trans)值降低。结论 (1)中、低分化组直肠癌的ADC_(mean)值与K~(trans)值有一定相关性。(2)高分化组与中、低分化组ADC_(mean)值与K~(trans)值相关性存在差异,对判断直肠癌的病理分化、恶性程度有重要的指导意义。

The correlation between ADC value and DCE-MRI parameters of magnetic resonance imaging in different degree of differentiation ofrectal cancer

Objective: To investigate the correlation between ADC value and the characteristics of dynamic contrast-enhanced MRI (DCE-MRI) parameters in the diagnosis of rectal cancer with different degree of differentiation. Materials and Methods: According to the degree of differentiation of the tumor, 102 cases of rectal adenocarcinoma were divided into: well differentiated group (n=23), moderately differentiated group (n=59) and poorly differentiated group (n=20). The DWI and DCE-MRI images of different groups were retrospectively analyzed, their ADCmean values, Ktrans, Ve and Kep values were measured, and the correlation between ADCmean value and Ktrans, Ve and Kep values in different groups was analyzed. Results: The values of ADCmean, Ktrans, Ve, Kep in well differentiation group were: (1.13±0.25) mm2/s, (0.28±0.09) min-1, (0.46±0.15), (0.67±0.18) min-1; The values of ADCmean, Ktrans,Ve, Kep in moderately differentiation group were: (0.94±0.05) mm2/s, (0.28±0.09) min-1, (0.52±0.24), (0.63 ±0.25) min-1; The values of ADCmean, Ktrans, Ve, Kep in poorly differentiation group were: (0.79±0.07) mm2/s, (0.40 ±0.08) min-1, (0.67±0.16), (0.66±0.15) min-1, Kep values between the groups and Ktrans, Ve between the moderately-well differentiated group were not statistically significant (P<0.05), and the rest were statistically significant (P<0.05). In poorly and moderately differentiation group of rectal cancer, the ADCmean and Ktrans value was negatively correlated (rmoderately=0.34, rpoorly=0.60, P<0.05). The Pearson analysis of ADCmean and Ve, Kep value in different differentiation group was P>0.05, the difference was not statistically significant. With the increase of the degree of differentiation of rectal cancer, ADCmean value increased, Ktrans value decreased. Conclusion: (1) There was a certain correlation between ADCmean value and Ktrans value of rectal cancer in poorly and moderately differentiation group. (2) The correlation between ADCmean value and Ktrans value of the well differentiation group and the moderately and poorly differentiation group were different, which had important guiding significance to determine the pathological differentiation and malignant degree of rectal cancer.