摘要
目的探讨动态增强磁共振成像(DCE-MRI)定量参数在结直肠癌临床诊断中的应用价值。方法回顾性分析2019年1月—2022年12月四川省彭州市人民医院收治的83例结直肠肿瘤患者的临床资料,患者均接受DCE-MRI检查,分析DCE-MRI在结直肠临床诊断及分期中的评估效能。结果病理结果显示,83例患者中结直肠癌53例,结直肠良性肿瘤30例。结直肠癌患者血液回流常数(K_(ep))、容量转移常数(K^(trans))、细胞外血管外间隙容积分数(Ve)均高于结直肠良性肿瘤患者,差异均有统计学意义(P<0.05);结直肠癌与结直肠良性肿瘤患者最大斜率(Max Slope)、对比剂时间-浓度曲线下面积(AUC)、最大浓度值(Max Conc)、达峰时间(TTP)比较,差异均无统计学意义(P>0.05)。受试者工作特征(ROC)曲线分析结果显示,DCE-MRI定量参数K_(ep)、K^(trans)、Ve诊断结直肠良恶性肿瘤的AUC值分别为0.75、0.73、0.74(95%CI:0.645~0.866、0.616~0.846、0.643~0.852,均P<0.001)。随着患者T分期增大,K_(ep)、K^(trans)、Ve逐渐上升,且不同T分期患者K_(ep)、K^(trans)、Ve比较,差异均有统计学意义(P<0.05);随着患者N分期增大,K_(ep)、K^(trans)、Ve逐渐上升,且不同N分期患者K_(ep)、K^(trans)、Ve比较,差异均有统计学意义(P<0.05);不同T分期和不同N分期患者Max Slop、AUC、Max Conc、TTP比较,差异均无统计学意义(P>0.05)。Spearman相关分析结果显示,T分期与K_(ep)、K^(trans)、Ve呈正相关(r_(s)=0.513、0.411、0.673,均P<0.05);N分期与K_(ep)、K^(trans)、Ve也呈正相关(r_(s)=0.615、0.542、0.396,均P<0.05)。结论DCE-MRI定量参数用于结直肠癌临床诊断有一定价值,且与患者临床分期关系密切,可用于评估患者病情。
Objective This paper aims to investigate the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the clinical diagnosis of colorectal cancer.Methods The clinical data of 83 patients with colorectal tumors admitted to Pengzhou People's Hospital from January 2019 to December 2022 were analyzed retrospectively.All patients underwent DCE-MRI.The efficacy of DCE-MRI in the clinical diagnosis and staging of colorectal tumors was analyzed.Results Of the 83 patients,pathological results showed that 53 had colorectal cancer and 30 had benign colorectal tumors.The efflux rate constant(K_(ep)),volume transfer rate constant(K^(trans))and extravascular,extracellular volume fraction(Ve)in patients with colorectal cancer were significantly higher than those in patients with benign colorectal tumors(P<0.05).No significant differences were observed in the maximum slope(Max Slope),area under the curve of the contrast agent time-concentration(AUC),maximum concentration(Max Conc),and time to peak(TTP)between patients with colorectal cancer and benign colorectal tumors(P>0.05).Receiver operating characteristic(ROC)curve analysis showed that the AUC values of DCE-MRI quantitative parameters K_(ep),K^(trans),and Ve in the diagnosis of benign and malignant colorectal tumors were 0.75,0.73,and 0.74,respectively(95%CI:0.645-0.866,0.616-0.846,and 0.643-0.852,all P<0.001).With the increase of the T stage,K_(ep),K^(trans),and Ve gradually increased,and there were significant differences in K_(ep),K^(trans),and Ve among patients with different T stages(P<0.05).With the increase of the N stage,K_(ep),K^(trans),and Ve gradually increased,and there were significant differences in K_(ep),K^(trans),and Ve among patients with different N stages(P<0.05).No significant differences were found in Max Slop,AUC,Max Conc,and TTP among patients with different T stages and N stages(P>0.05).Spearman correlation analysis showed that the T stage was positively correlated with K_(ep),K^(trans),and Ve(r_(s)=0.513,0.411,and 0.673,all P<0.05);the N stage was also positively correlated with K_(ep),K^(trans),and Ve(r_(s)=0.615,0.542,and 0.396,all P<0.05).Conclusion DCE-MRI quantitative parameters are valuable in the clinical diagnosis of colorectal cancer and are closely correlated with the clinical stage of patients,which can be used to evaluate the patient's condition.
作者
王大浒
谢陈
李群兰
廖庆
王鑫
尹俊吉
Wang Dahu;Xie Chen;Li Qunlan;Liao Qing;Wang Xin;Yin Junji(Department of Radiology,Pengzhou People's Hospital,Pengzhou Sichuan 611930,China;Department of Radiology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)
出处
《保健医学研究与实践》
2023年第8期47-52,共6页
Health Medicine Research and Practice
基金
四川省卫生健康委员会科研课题(20PJ0283)。
关键词
动态增强磁共振成像
定量参数
结直肠癌
临床诊断
临床分期
诊断效能
Dynamic contrast-enhanced magnetic resonance imaging
Quantitative parameters
Colorectal cancer
Clinical diagnosis
Clinical staging
Diagnostic efficacy
