摘要
目的探讨动态增强磁共振成像(DCE-MRI)在直肠癌术前评估分化程度中的临床价值。方法搜集40例经病理证实的直肠癌患者及非直肠癌的15例受试者(对照组)的DCE-MRI检查资料。由2名医师采用盲法阅片,应用Tofts模型后处理得到感兴趣区(ROI)的微循环参数容积转移常数(Ktrans)、速率常数(Kep)、体积百分数(Ve)及增强的曲线下面积(i AUC)值。绘制时间-信号强度曲线。根据病理诊断结果制作受试者工作特征曲线(ROC),计算分析DCE-MRI各参数的ROC曲线下面积,分析2名医师测量结果的一致性。将患者组的DCE-MRI参数结果与术后病理分化程度进行相关性分析。结果患者组的Ktrans值、Kep值、Ve值、i AUC值均较对照组升高(均P<0.05)。直肠癌病灶的时间-信号强度曲线表现为流出型。参数Ktrans、i AUC的ROC曲线下面积较大,分别为医师1:0.987、0.975;医师2:0.990、0.978。2名医师测量各参数的组内相关系数(ICC)分别为0.991、0.988、0.972、0.984,观测结果有良好一致性。40例直肠癌中,病灶Ktrans值、i AUC值与病理分化程度具有一定程度的相关性,r值分别为医师1:0.393、0.594;医师2:0.443、0.659(均P<0.05)。结论 DCE-MRI能反映直肠癌的微循环差异,其参数指标与直肠癌分化程度存在一定程度的相关性,对直肠癌的术前评估有一定作用。
Objective To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） for the diagnosis of rectal cancer. Methods 40 patients with histologically proven rectal cancer and 15 patients without rectal cancer were studied by DCE-MRI. Two doctors who were blind to the history of the patients interpreted the imaging findings, all of the data was transferred to workstation to analysise the microcirculation parameters of region of interest by using the Tofts model, which included Ktrans, Kep, Ve, iAUC, and analysis of consistency of two doctors＂ meas- urement results. The time-signal intensity curve was drawn. The receiver operating characteristic curve （ROC）was made and calculated the area under the curve. Comparison with the postoperative pathology was done and, the 40 patients＇results were statistically analyzed. Results The values of Ktr~＂~ ,Kev, Ve, iAUC in patients＂ group were higher than that in the control group（P 〈 0.05）, both in the two doctors＂ measurement results. The time-signal intensity curve is Outflow type. The area under the curve of the K and iAUC is larger, doctor 1：0. 987,0. 975 ;doctor 2：0. 990,0. 980. The Intraclass Correlation Coefficient （ICC） of all parameters between the two doctors＇data were 0. 991, 0.988, 0. 972, 0. 984, have a good consistency. For the 40 patients, the value of K^trans and iAUC has a positive correlation with the degree of pathological differentiation, P 〈 0.05. Conclusion The DCE-MRI have a relationship with the degree of differentiation by using the parameters which reflect the blood supply in the rectal cancer, so the DCE-MRI was valuable for the preoperative evaluation of rectal cancer.
出处
《临床放射学杂志》
CSCD
北大核心
2016年第1期96-100,共5页
Journal of Clinical Radiology
