体素内不一致运动序列评估直肠癌术前病理分级的可行性研究

发布时间：2018-05-15 09:53

本文选题：直肠癌 + 体素内不一致运动序列　；参考：《临床放射学杂志》2015年12期

【摘要】：目的初步探讨直肠癌体素内不一致运动磁共振成像(IVIM-MRI)序列的成像特点,进一步研究探讨IVIM参数标准ADC、真实扩散系数(D)、灌注相关扩散系数(D*)、灌注分数(f)及表观扩散系数(ADC)值对直肠癌术前病理分级的评估价值。方法分析30例经手术病理证实为直肠癌患者的IVIM参数标准ADC、D、D*、f值及DWI资料,结合病理结果,分析在肿瘤不同分化程度、T分期及N分期中的区别。结果 D在直肠癌分化程度组、T分期组的差异有统计学意义(F值分别为3.700、12.846;P0.05),ADC值在直肠癌分化程度组、T分期组的差异有统计学意义(F值分别为3.823、7.881;P0.05),两者在N分期组中差异均无统计学意义(F值分别为0.510、0.214;P0.05)。多重比较显示肿瘤分化程度组的高-中分化组与中分化组[95%可信区间(*104):0.358~4.608,P=0.018]、中-低分化组[95%可信区间(*104):0.1578~4.819,P=0.033]的D值差异有统计学意义(P0.05),肿瘤分化程度组的高-中分化组与中分化组[95%可信区间(*104):4.968~52.34,P=0.013]、中-低分化组[95%可信区间(*104):1.73~53.689,P=0.033]的ADC值差异有统计学意义(P0.05);肿瘤T分期中T1期与其他三期之间的D值[95%可信区间(*104)分别为:1.167~5.135、1.868~5.872、2.358~6.362]差异有统计学意义(P0.05),肿瘤T分期中T1期与其他三期之间的ADC值[95%可信区间(*104)分别为:15.945~66.615、17.09~68.227、17.562~68.698]差异有统计学意义(P0.05),T2期与T4期之间的D值差异有统计学意义[95%可信区间(*104):0.032~2.386,P0.05]。各参数在N0期~N2期之间差异均无统计学意义(P0.05)。结论 D及ADC值可在一定程度上反映直肠癌的病理分级,并可以初步认为,相较于常规ADC值,D值可以更客观准确地评估肿瘤的恶性程度。
[Abstract]:Objective to investigate the imaging characteristics of IVIM-MRI sequence of incoherent motion MRI in rectal cancer. To further study the value of IVIM parameter standard, real diffusion coefficient, perfusion correlation diffusion coefficient, perfusion fraction and apparent diffusion coefficient in preoperative pathological grading of rectal cancer. Methods the IVIM parameters and DWI data of 30 patients with rectal cancer proved by operation and pathology were analyzed. The difference between T stage and N stage of tumor with different differentiation degree was analyzed in combination with pathological results. Results the difference between D and T staging group was significant (F = 3.700 ~ 12.846 / P 0.05). There was significant difference between D and T staging group (3.8237.881 / P 0.05), respectively. The difference between the two groups in N stage group was lower than that in N stage group. The difference was significant in the T stage group of rectal cancer differentiation degree group (P < 0.05), and the difference between the two groups was significant (P < 0.05), and the difference between the two groups was significant (P < 0.05). There was no significant difference in F value between 0. 510 and 0. 214m P 0. 05, respectively. Multiple comparisons showed that there were significant differences in D values between high and medium differentiation group and medium differentiated group [95% confidence interval 1044% 0.358% 4.608% P0. 018] and middle to low differentiation group [95% confidence interval 104% 0.1578% 4.819% P0. 033]. There was significant difference in D value between high to middle differentiation group and high to middle differentiation group of tumor differentiation degree group (P 0. 05). The ADC value of middle differentiation group [95% confidence interval] [95% confidence interval] had statistical significance (P 0.05); the D value of T _ 1 stage and other three stages in T _ 1 stage were 1.1675.135 ~ 1.868 ~ 5.8722.3586.362 respectively] there was significant difference in ADC value between T _ 1 stage and other three stages. [95% confidence interval = 1.1675.135U 1.8685.8722.3586.362] there was a significant difference in ADC value between T _ 1 stage and other three stages in T _ 1 stage (95% confidence interval = 1.1675.135n = 1.8685.8722.3586.362). The ADC value of T 1 stage and the other three stages in T stage of tumor were: 1: 15.945 / 66.615 / 17.09 68.227 / 17.562 / 68.698 respectively. There was significant difference in D value between T _ 2 stage and T _ 4 stage [95% confidence interval (95% confidence interval) = 104w / 0.032: 2.386p0.05], and there was a significant difference between T _ 1 and T _ 4 stage in T _ 1 stage and T _ 4 stage [95% confidence interval (95% confidence interval) was 0.032: 2.386p0.05]. There was significant difference in D value between T _ 2 stage and T _ 4 stage in T _ 1 stage. There was no significant difference in the parameters between N 0 and N 2 stages (P 0.05). Conclusion D and ADC values can reflect the pathological grade of rectal cancer to a certain extent, and it can be preliminarily considered that compared with the conventional ADC value, D value can be used to evaluate the malignant degree of the tumor more objectively and accurately.
【作者单位】：郑州大学附属肿瘤医院河南省肿瘤医院放射科;
【分类号】：R735.37;R445.2

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