BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the e...BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index （EVLWI） in patients with acute respiratory distress syndrome （ARDS）. METHODS：Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index （PaO2/FiO2）, peak inspiratory pressure （PIP）, Plateau pressure （Pplat）, static pulmonary compliance （Cst） and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student＇s t test and Fisher＇s exact test were used to process the data. RESULTS：The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group （P〈0.05）. The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group （P〈0.05）. The EVLWI in the two groups showed downward trend after treatment （P〈0.05）, and the differences were signifcant at all time points （P〈0.01）; the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours （P〈0.05 or P〈0.01）. Compared with pre-RM, hemodynamics changes during RM were significantly different （P〈0.01）; compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM （P〉0.05）. CONCLUSIONS： RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.展开更多
BACKGROUND Computer tomography angiography(CTA) has been an established method for diagnostic vascular disease of lower limbs. Recently, the method is widely used for diagnosis of vascular pathologies in the upper lim...BACKGROUND Computer tomography angiography(CTA) has been an established method for diagnostic vascular disease of lower limbs. Recently, the method is widely used for diagnosis of vascular pathologies in the upper limbs too. It also has increased the possibilities of this scans being reviewed by no specially trained radiologists.This increases the risk of incidental non vascular findings to be missed or misinterpreted. The study is focusing in the frequency of extravascular incidental finding(EVIF) and highlights the importance for both the reporting radiologist and the referring physician recognizing the frequency of EVIFs.AIM To analyse the frequency of EVIF identified on computed angiography(CT) of the upper limb.METHODS A total of 1383 CT angiographic studies of the peripheral arterial system were performed between August 2015 and August 2017. All upper limb CTAs(n = 79)were retrospectively reviewed for the presence of non-vascular incidental findings within the chest, abdomen/pelvis, musculoskeletal system or head and neck. These EVIFs were subsequently grouped into 3 categories based on clinical significance. EVIFs of immediate clinical relevance were included in category A,findings considered indeterminate but most likely benign were placed in category B, while incidental findings of no clinical significance were included in category C.RESULTS Complete imaging datasets were available in 74/79(93.7%). Patientdemographics included 39(52.7%) females and 35(47.2%) males with a mean age of 59 ± 19.5 years(range 19-93 years). A total of 153 EVIFs were reported in 52 patients(70.3%). Of these, 44 EVIFs(28.7%) were found in the chest, 83(54.2%) in the abdomen, 14(9.2%) in the musculoskeletal system and 9(5.8%) in the head and neck. Thirteen EVIFs(8.4%) identified in 11 patients were noted to be of immediate clinical significance(Category A), 50 EVIFs(32.3%) were identified in20 patients and were considered indeterminate but most likely benign, while the remaining 91 EVIFs(59.5%) identified in 21 patients were determined to be of no clinical significance(Category C). One index case of malignancy(1.3%) and four cases of new disseminated metastatic disease(5.4%) were identified.CONCLUSION Our study of upper limb CTA examinations demonstrated a frequency of 8.4%for extravascular incidental findings of immediate clinical significance. We highlight the importance for both the reporting radiologist and the referring physician of the need to recognize the frequency with which EVIFs are identified in the upper limb peripheral arterial system and of the necessity for further clinical and imaging work-up.展开更多
The accumulation of extravascular lung water （EVLW） after cardiac surgery of congenital heart disease may predicted from the preoperative level of pulmonary blood flow. This accumulation of EVLW may adversely affect...The accumulation of extravascular lung water （EVLW） after cardiac surgery of congenital heart disease may predicted from the preoperative level of pulmonary blood flow. This accumulation of EVLW may adversely affect ventilatory parameters. Lung compliance （LC）, cardiac index （CI）, blood arterial oxygen tension （PaO<sub>2</sub>）, left atrial pressure （LAP）and EVLW were measured serially immediately postoperative in two groups of children after complete repair of congenital heart disease contrasted by their level of pulmonary blood flow: Tetralogy of Fallot （TOF, n=10, 4.6±1.9 years） and ventrvcular septal defect with pulmonary arterial hypertension （VSD+PAH, n=10, 5.4±2.0 years）.Using a double indicator-dilution technique （DIDT） the EVLW peaked at the 16th hour postoperation in TOF group and at the 8 th hour postoperation inthe VSD with PAH group. During the first 24 hours after surgery the EVLW was consistently higher in the VSD with PAH group （P【0.01）. There was a negative correlation between the EVLW and LC, CI and PaO<sub>2</sub> and no correlation between the EVLW and LAP. In three hypoxemic patients of the VSD with PAH group the LC deteriorated while the EVLW was elevated. After treatment with positive end expiratory pressure （PEEP） the hypoxemia corrected as the LC increased and the EVLW decreased, with no change in the CI. Thus, measurement of EVLW provides a sensitive method for explaining changes in LC, that may lead to a more rational adjustment of mechanical ventilator parameters.展开更多
AIM: To investigate extravascular lung water indexed to predicted body weight(EVLWIp) and actual body weight(EVLWIa) on outcome of patients with severe sepsis.METHODS: Transpulmonary thermodilution was prospectively u...AIM: To investigate extravascular lung water indexed to predicted body weight(EVLWIp) and actual body weight(EVLWIa) on outcome of patients with severe sepsis.METHODS: Transpulmonary thermodilution was prospectively used to measure cardiovascular hemodynamics, EVLWIp and EVLWIa via an arterial catheter placed in each patient within 48 h of meeting the criteria for severe sepsis from a medical intensive care unit(ICU) at a university affiliated hospital. Survival was the single dependent variable. In order to examine and compare the predictive power of EVLWIp, EVLWIa and other clinically significant factors in predicting the inhospital survival status of severe sepsis patients in the medical ICU, a receiver operating characteristic(ROC) curve method to analyze the significant variables and the area under the ROC curve(AUC) of the variables, P value and 95%CI were calculated.RESULTS: In total, 33 patients were studied. In the ROC curve method analyses, EVLWIp(the AUC: 0.849; P = 0.001, 95%CI: 0.72-0.98) was as predictive for inhospital survival rate as variables with EVLWIa(AUC, 0.829; P = 0.001, 95%CI: 0.68-0.98). The proportion of patients surviving with a low EVLW(EVLWI < 10 m L/kg) was better than that of patients with a higher EVLW, whether indexed by actual(HR = 0.2; P = 0.0002, 95%CI: 0.06-0.42) or predicted body weight(HR = 0.13; P < 0.0001, 95%CI: 0.05-0.35) during their hospital stay with the Kaplan-Meier method(76% vs 12.5%, respectively).CONCLUSION: This investigation proposed that EVLWIp is as good a predictor as EVLWIa to predict inhospital survival rate among severe sepsis patients in the medical ICU.展开更多
Background: This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (E...Background: This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications. Method: The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV’s primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed. Results: The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7°± 4.3° to 48.0°± 8.8°(P < 0.05);in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ± 0.5 to 1.3 ± 0.2 mm (P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ± 3.3 to 18.5 ± 3.4 cm/s (P < 0.05). No side effects were observed in the 24 to 42 months following surgery. Conclusion: The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.展开更多
To the Editor:Posterior nutcracker syndrome (PNS)is a condition caused by compression of the left renal vein (LRV)between the vertebral column and the aorta (AO).Open surgery with LRV transposition has usually been re...To the Editor:Posterior nutcracker syndrome (PNS)is a condition caused by compression of the left renal vein (LRV)between the vertebral column and the aorta (AO).Open surgery with LRV transposition has usually been recommended for patients with PNS.[1,4]However,existing surgical means of treatment are not sufficiently safe,effective,or minimally invasive.Here,we present one case of PNS treated with three-dimensional (3D)printed extravascular stent placement using laparoscopy.展开更多
During the spring of 2009, a pandemic novel influenza A （H1NI） virus emerged and spread globally. As of January 3, 2009, more than 208 countries and overseas territories or communities have reported laboratoryconfir...During the spring of 2009, a pandemic novel influenza A （H1NI） virus emerged and spread globally. As of January 3, 2009, more than 208 countries and overseas territories or communities have reported laboratoryconfirmed cases of pandemic influenza H1N1 2009, including at least 12 799 death cases.1 Critical cases developed severe acute respiratory distress syndrome （ARDS） rapidly, which was refractory to conventional mechanical ventilation and rescue therapies.展开更多
The management of patients with colorectal cancer(CRC)mainly lies on the use of magnetic resonance imaging(MRI)technique as a diagnostic tool for both staging and restaging.AIM To explore the preoperative value of qua...The management of patients with colorectal cancer(CRC)mainly lies on the use of magnetic resonance imaging(MRI)technique as a diagnostic tool for both staging and restaging.AIM To explore the preoperative value of quantitative parameters of dynamic contrastenhanced MRI(DCE-MRI)in evaluating clinical stages of CRC.METHODS A total of 86 CRC patients undergoing DCE-MRI examinations were included and then classified into CRC group(n=46)and benign tumor group(n=40)according to surgical and pathological results.Quantitative parameters of DCE-MRI,including volume transfer constant(Ktrans),rate constant(Kep)and extravascular extracellular volume fraction(Ve),were analyzed between two groups and among CRC at different stages.Receiver operating characteristic(ROC)curves with of quantitative parameters of DCE-MRI for clinical diagnosis and preoperative staging of CRC were plotted.RESULTS The CRC group had 9 cases with tumor in the upper segment,21 cases in the middle segment,16 in the low segment,10 cases with well differentiation,27 cases with moderate differentiation,and 9 cases with poor differentiation.The Ktrans,Kep,and Ve in the CRC group were higher than those in the benign tumor group(P<0.05).The ROC curves indicated that the optimal cutoff values of Ktrans,Kep and Ve for diagnosing CRC were 0.905 minute-1,0.225 minute-1 and 0.585%,respectively.The Ktrans,Kep and Ve as a combined tool to diagnose CRC yielded 0.863 of area under the curve and 82.60%of sensitivity,and both values were higher than those yielded by Ktrans,Kep,or Ve alone(P<0.05).The Ktrans,Kep and Ve in CRC patients at T3-T4 stage or N1-N2 stage were higher than those at T1-T2 stage or N0 stage(P<0.05).Results of Spearman correlation analysis showed that the Ktrans,Kep and Ve were correlated with advanced T and N stages in CRC patients(P<0.05).The ROC results indicated that the Ktrans produced a higher specificity(81.48%)and sensitivity(94.70%)in evaluating preoperative T stage of CRC.The Kep generated a higher specificity(96.00%)and sensitivity(81.00%)in evaluating preoperative N stage of CRC.CONCLUSION The study suggests that the values of Ktrans,Kep and Ve of DCE-MRI exhibit good performance in diagnosing CRC and preoperative assessment of clinical stages.However,relatively small sample size should be considered for data interpretation.展开更多
文摘BACKGROUND：Animal experiments showed that recruitment maneuver （RM） and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index （EVLWI） in patients with acute respiratory distress syndrome （ARDS）. METHODS：Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index （PaO2/FiO2）, peak inspiratory pressure （PIP）, Plateau pressure （Pplat）, static pulmonary compliance （Cst） and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student＇s t test and Fisher＇s exact test were used to process the data. RESULTS：The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group （P〈0.05）. The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group （P〈0.05）. The EVLWI in the two groups showed downward trend after treatment （P〈0.05）, and the differences were signifcant at all time points （P〈0.01）; the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours （P〈0.05 or P〈0.01）. Compared with pre-RM, hemodynamics changes during RM were significantly different （P〈0.01）; compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM （P〉0.05）. CONCLUSIONS： RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.
文摘BACKGROUND Computer tomography angiography(CTA) has been an established method for diagnostic vascular disease of lower limbs. Recently, the method is widely used for diagnosis of vascular pathologies in the upper limbs too. It also has increased the possibilities of this scans being reviewed by no specially trained radiologists.This increases the risk of incidental non vascular findings to be missed or misinterpreted. The study is focusing in the frequency of extravascular incidental finding(EVIF) and highlights the importance for both the reporting radiologist and the referring physician recognizing the frequency of EVIFs.AIM To analyse the frequency of EVIF identified on computed angiography(CT) of the upper limb.METHODS A total of 1383 CT angiographic studies of the peripheral arterial system were performed between August 2015 and August 2017. All upper limb CTAs(n = 79)were retrospectively reviewed for the presence of non-vascular incidental findings within the chest, abdomen/pelvis, musculoskeletal system or head and neck. These EVIFs were subsequently grouped into 3 categories based on clinical significance. EVIFs of immediate clinical relevance were included in category A,findings considered indeterminate but most likely benign were placed in category B, while incidental findings of no clinical significance were included in category C.RESULTS Complete imaging datasets were available in 74/79(93.7%). Patientdemographics included 39(52.7%) females and 35(47.2%) males with a mean age of 59 ± 19.5 years(range 19-93 years). A total of 153 EVIFs were reported in 52 patients(70.3%). Of these, 44 EVIFs(28.7%) were found in the chest, 83(54.2%) in the abdomen, 14(9.2%) in the musculoskeletal system and 9(5.8%) in the head and neck. Thirteen EVIFs(8.4%) identified in 11 patients were noted to be of immediate clinical significance(Category A), 50 EVIFs(32.3%) were identified in20 patients and were considered indeterminate but most likely benign, while the remaining 91 EVIFs(59.5%) identified in 21 patients were determined to be of no clinical significance(Category C). One index case of malignancy(1.3%) and four cases of new disseminated metastatic disease(5.4%) were identified.CONCLUSION Our study of upper limb CTA examinations demonstrated a frequency of 8.4%for extravascular incidental findings of immediate clinical significance. We highlight the importance for both the reporting radiologist and the referring physician of the need to recognize the frequency with which EVIFs are identified in the upper limb peripheral arterial system and of the necessity for further clinical and imaging work-up.
文摘The accumulation of extravascular lung water （EVLW） after cardiac surgery of congenital heart disease may predicted from the preoperative level of pulmonary blood flow. This accumulation of EVLW may adversely affect ventilatory parameters. Lung compliance （LC）, cardiac index （CI）, blood arterial oxygen tension （PaO<sub>2</sub>）, left atrial pressure （LAP）and EVLW were measured serially immediately postoperative in two groups of children after complete repair of congenital heart disease contrasted by their level of pulmonary blood flow: Tetralogy of Fallot （TOF, n=10, 4.6±1.9 years） and ventrvcular septal defect with pulmonary arterial hypertension （VSD+PAH, n=10, 5.4±2.0 years）.Using a double indicator-dilution technique （DIDT） the EVLW peaked at the 16th hour postoperation in TOF group and at the 8 th hour postoperation inthe VSD with PAH group. During the first 24 hours after surgery the EVLW was consistently higher in the VSD with PAH group （P【0.01）. There was a negative correlation between the EVLW and LC, CI and PaO<sub>2</sub> and no correlation between the EVLW and LAP. In three hypoxemic patients of the VSD with PAH group the LC deteriorated while the EVLW was elevated. After treatment with positive end expiratory pressure （PEEP） the hypoxemia corrected as the LC increased and the EVLW decreased, with no change in the CI. Thus, measurement of EVLW provides a sensitive method for explaining changes in LC, that may lead to a more rational adjustment of mechanical ventilator parameters.
基金Supported by Grants from Taiwan National Science Council,No.NSC-100-2314-B-182A-054Chang Gung Memorial Hospital,Nos.CMRPG3B0831,CMRPG3B0832 and CMRPG3A0562
文摘AIM: To investigate extravascular lung water indexed to predicted body weight(EVLWIp) and actual body weight(EVLWIa) on outcome of patients with severe sepsis.METHODS: Transpulmonary thermodilution was prospectively used to measure cardiovascular hemodynamics, EVLWIp and EVLWIa via an arterial catheter placed in each patient within 48 h of meeting the criteria for severe sepsis from a medical intensive care unit(ICU) at a university affiliated hospital. Survival was the single dependent variable. In order to examine and compare the predictive power of EVLWIp, EVLWIa and other clinically significant factors in predicting the inhospital survival status of severe sepsis patients in the medical ICU, a receiver operating characteristic(ROC) curve method to analyze the significant variables and the area under the ROC curve(AUC) of the variables, P value and 95%CI were calculated.RESULTS: In total, 33 patients were studied. In the ROC curve method analyses, EVLWIp(the AUC: 0.849; P = 0.001, 95%CI: 0.72-0.98) was as predictive for inhospital survival rate as variables with EVLWIa(AUC, 0.829; P = 0.001, 95%CI: 0.68-0.98). The proportion of patients surviving with a low EVLW(EVLWI < 10 m L/kg) was better than that of patients with a higher EVLW, whether indexed by actual(HR = 0.2; P = 0.0002, 95%CI: 0.06-0.42) or predicted body weight(HR = 0.13; P < 0.0001, 95%CI: 0.05-0.35) during their hospital stay with the Kaplan-Meier method(76% vs 12.5%, respectively).CONCLUSION: This investigation proposed that EVLWIp is as good a predictor as EVLWIa to predict inhospital survival rate among severe sepsis patients in the medical ICU.
文摘Background: This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications. Method: The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV’s primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed. Results: The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7°± 4.3° to 48.0°± 8.8°(P < 0.05);in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ± 0.5 to 1.3 ± 0.2 mm (P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ± 3.3 to 18.5 ± 3.4 cm/s (P < 0.05). No side effects were observed in the 24 to 42 months following surgery. Conclusion: The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.
文摘To the Editor:Posterior nutcracker syndrome (PNS)is a condition caused by compression of the left renal vein (LRV)between the vertebral column and the aorta (AO).Open surgery with LRV transposition has usually been recommended for patients with PNS.[1,4]However,existing surgical means of treatment are not sufficiently safe,effective,or minimally invasive.Here,we present one case of PNS treated with three-dimensional (3D)printed extravascular stent placement using laparoscopy.
文摘During the spring of 2009, a pandemic novel influenza A （H1NI） virus emerged and spread globally. As of January 3, 2009, more than 208 countries and overseas territories or communities have reported laboratoryconfirmed cases of pandemic influenza H1N1 2009, including at least 12 799 death cases.1 Critical cases developed severe acute respiratory distress syndrome （ARDS） rapidly, which was refractory to conventional mechanical ventilation and rescue therapies.
文摘The management of patients with colorectal cancer(CRC)mainly lies on the use of magnetic resonance imaging(MRI)technique as a diagnostic tool for both staging and restaging.AIM To explore the preoperative value of quantitative parameters of dynamic contrastenhanced MRI(DCE-MRI)in evaluating clinical stages of CRC.METHODS A total of 86 CRC patients undergoing DCE-MRI examinations were included and then classified into CRC group(n=46)and benign tumor group(n=40)according to surgical and pathological results.Quantitative parameters of DCE-MRI,including volume transfer constant(Ktrans),rate constant(Kep)and extravascular extracellular volume fraction(Ve),were analyzed between two groups and among CRC at different stages.Receiver operating characteristic(ROC)curves with of quantitative parameters of DCE-MRI for clinical diagnosis and preoperative staging of CRC were plotted.RESULTS The CRC group had 9 cases with tumor in the upper segment,21 cases in the middle segment,16 in the low segment,10 cases with well differentiation,27 cases with moderate differentiation,and 9 cases with poor differentiation.The Ktrans,Kep,and Ve in the CRC group were higher than those in the benign tumor group(P<0.05).The ROC curves indicated that the optimal cutoff values of Ktrans,Kep and Ve for diagnosing CRC were 0.905 minute-1,0.225 minute-1 and 0.585%,respectively.The Ktrans,Kep and Ve as a combined tool to diagnose CRC yielded 0.863 of area under the curve and 82.60%of sensitivity,and both values were higher than those yielded by Ktrans,Kep,or Ve alone(P<0.05).The Ktrans,Kep and Ve in CRC patients at T3-T4 stage or N1-N2 stage were higher than those at T1-T2 stage or N0 stage(P<0.05).Results of Spearman correlation analysis showed that the Ktrans,Kep and Ve were correlated with advanced T and N stages in CRC patients(P<0.05).The ROC results indicated that the Ktrans produced a higher specificity(81.48%)and sensitivity(94.70%)in evaluating preoperative T stage of CRC.The Kep generated a higher specificity(96.00%)and sensitivity(81.00%)in evaluating preoperative N stage of CRC.CONCLUSION The study suggests that the values of Ktrans,Kep and Ve of DCE-MRI exhibit good performance in diagnosing CRC and preoperative assessment of clinical stages.However,relatively small sample size should be considered for data interpretation.
