动态对比增强MRI联合体素内不相干运动术前评估直肠癌病理分型

目的 观察动态对比增强MRI(DCE-MRI)联合体素内不相干运动(IVIM)术前评估直肠癌病理类型的价值。方法 纳入81例直肠腺癌患者，根据术后病理结果分为黏液腺癌组(n=36)和非黏液腺癌组(n=45);比较组间DCE-MRI参数及IVIM参数，包括速率常数(K_ep)、容积转运常数(K^trans)、血管外细胞外间隙容积分数(V_e),以及真弥散系数(D)、假弥散系数(D^*)、灌注分数(f);行logistic回归分析，观察上述参数术前诊断直肠癌病理分型的效能。结果 黏液腺癌组K_ep、K^trans、D^*和f均小于非黏液腺癌组(P均<0.05);其中，K_ep和f为直肠癌病理分型的影响因素(P均<0.05)。术前以K_ep、f及二者联合评估直肠癌病理分型的曲线下面积(AUC)分别为0.774、0.880和0.906,敏感度为69.44%、77.78%和86.11%,特异度为82.22%...

Dynamic contrast enhanced MRI combined with intravoxel incoherent motion for preoperative evaluation on pathological type of rectal cancer

Objective To observe the value of dynamic contrast enhanced MRI (DCE-MRI) combined with intravoxel incoherent motion (IVIM) for preoperative evaluation on pathological type of rectal cancer. Methods Totally 81 patients with rectal adenocarcinoma were enrolled and divided into mucinous adenocarcinoma group (n=36) or non mucinous adenocarcinoma group (n=45) based on postoperative pathological results. Parameters of DCE-MRI and IVIM, including rate constant (K_ep), volume transfer constant (K^trans), extravascular extracellular volume fraction (V_e), true diffusion coefficient (D), pseudo diffusion coefficient (D^*) and perfusion fraction (f) were compared between groups. Logistic regression analysis was performed, the efficacy of the above parameters for evaluation on pathological type of rectal cancer were explored. Results K_ep, K^trans, D^* and f of mucinous adenocarcinoma group were all smaller than those of non mucinous adenocarcinoma group (all P<0.05). K_ep and f were both impact factors of pathological type of rectal cancer (both P<0.05). The area under the curve (AUC) of K_ep, f and K_ep+f for preoperative evaluation on pathological type of rectal cancer was 0.774, 0.880 and 0.906, respectively, with sensitivity of 69.44%, 77.78% and 86.11%, specificity of 82.22%, 91.11% and 91.11%, respectively. AUC of K_ep was lower than that of K_ep+f (P<0.05). Conclusion DCE-MRI combined with IVIM could effectively evaluate the pathological type of rectal cancer preoperation.