Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer

Haiping ZHANG; Xinjie LIU; Xiangling YU; Dajing GUO; Xiaojing HE; Jun ZHOU; Yangyang LIU

doi:10.16016/j.1000-5404.201811205

您当前的位置：

首页 >

文章列表页 >

Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer

Clinical Medicine | 更新时间：2026-01-09

- Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer
- Journal of Third Military Medical University Vol. 41, Issue 11, Pages: 1070-1076(2019)
- 作者机构：
  
  400010 重庆，重庆医科大学附属第二医院放射科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201811205
  CLC： R445.2;R73-37;R735.37
- Received：28 November 2018，
  
  Revised：2019-01-14，
  
  Published：15 June 2019
- 稿件说明：
移动端阅览
Haiping ZHANG, Xinjie LIU, Xiangling YU, et al. Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer[J]. Journal of Third Military Medical University, 2019, 41(11): 1070-1076.
DOI：

Haiping ZHANG, Xinjie LIU, Xiangling YU, et al. Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer[J]. Journal of Third Military Medical University, 2019, 41(11): 1070-1076. DOI： 10.16016/j.1000-5404.201811205.

摘要

目的

探讨动态增强磁共振成像(dynamic contrast enhanced magnetic resonance imaging

DCE-MRI)定量及半定量参数术前评估直肠癌壁外血管侵犯(extramural venous invasion，EMVI)的价值。

方法

回顾性分析本院2016年11月至2018年6月行术前DCE-MRI检查及全直肠系膜筋膜切除手术的直肠癌患者76例，利用第三方后处理软件(omni kinetic，OK)提取肿瘤的DCE-MRI定量参数(Ktrans、Kep、Ve和Vp)和半定量参数(iAUC、TTP、Max Slope和Max Conc)，比较EMVI阳性组与阴性组间各参数值的差异，分析有价值参数的诊断效能以及与EMVI之间的相关性。

结果

两名医师提取的各参数值具有很好的一致性。EMVI阳性组的Ktrans值和Ve值显著大于阴性组(

0.05)，Kep值、Vp值及所有半定量参数在两组间差异均无统计学意义(

0.05)。Ktrans值和Ve值与EMVI具有一定正相关(Ktrans：

=0.353

=0.002；Ve：

=0.417

0.001)，当Ktrans值＞0.870或Ve值＞0.556时，对直肠癌EMVI具有较好的诊断效能(Ktrans曲线下面积：0.728；Ve曲线下面积：0.769)，且Ktrans在排除EMVI上具有较高的特异性(90.9%)，但两个参数联合应用未显著提高诊断效能(Ktrans+Ve曲线下面积：0.779)。

结论

DCE-MRI定量参数Ktrans和Ve对术前评估直肠癌EMVI具有重要的应用价值。

Abstract

Objective

To investigate the value of quantitative and semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in evaluation of the extramural venous invasion (EMVI) in rectal cancer.

Methods

A total of 76 patients with rectal cancer who underwent preoperative DCE-MRI examination and total mesorectal excision in our hospital from November 2016 to June 2018 were enrolled

and the results of the examination was collected and analyzed retrospectively. The entire tumor regions of interest (ROIs) for rectal cancer was drawn

and the quantitative [volume transfer constant (Ktrans)

rate constant (Kep)

volume fraction of extravascular extracellular space (Ve)

and volume fraction of plasma (Vp)] and semi-quantitative parameters [initial area under curve (iAUC)

time to peak (TTP)

Max Slope

and Max Conc] of DCE-MRI were extracted using a third-party post-processing software

Omni Kinetic (OK). Each of the parameters between the EMVI positive and the negative groups was compared to analyze their respective diagnostic efficacy

and the correlation between each parameter and EMVI was analyzed.

Results

The intraclass correlation coefficient for each parameter extracted by 2 physicians was excellent in this study. The Ktrans and Ve values were significantly h

igher in the EMVI positive group than the negative group (

0.05)

while the Kep and Vp values and the values of all semi-quantitative parameters showed no statistical differences between the 2 groups (

0.05). The Ktrans (

=0.353

=0.002) and Ve (

=0.417

0.001) values were positively correlated with EMVI

respectively. When the Ktrans value is larger than 0.870 or Ve value than 0.556

good diagnostic performance was obtained in identifying EMVI with the area under the curves (AUC) of 0.728 and 0.769

respectively

and Ktrans had a higher specificity (90.9%) in excluding EMVI. But

the combined application of the 2 parameters had no effect on improvement of diagnostic performance (AUC=0.779).

Conclusion

DCE-MRI quantitative parameters Ktrans and Ve values have important application value in preoperative evaluation of rectal cancer EMVI.

关键词

Keywords

references

JHAVERI K S, HOSSEINI-NIK H, THIPPHAVONG S, et al . MRI detection of extramural venous invasion in rectal cancer: correlation with histopathology using elastin stain[J ] . Am J Roentgenol, 2016, 206(4): 747-755. DOI:10.2214/AJR.15.15568.

TRIPATHI P, RAO S X, ZENG M S. Clinical value of MRI-detected extramural venous invasion in rectal cancer[J]. J Dig Dis, 2017, 18(1):2-12. DOI:10.1111/1751-2980.12439.

ZHANG X Y, WANGS, LI X T, et al . MRI of extramural venous invasion in locally advanced rectal cancer: relationship to tumor recurrence and overall survival[J ] . Radiology, 2018, 289(3): 677-685. DOI:10.1148/radiol.2018 172889.

SOHN B, LIM J S, KIM H, et al . MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer[J ] . Eur Radiol, 2015, 25(5): 1347-1355. DOI:10.1007/s00330-014-3527-9.

SMITH N J, BARBACHANO Y, NORMAN A R, et al . Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer[J ] . Br J Surg, 2008, 95(2):229-236. DOI: 10.1002/bjs.5917.

BROWN G, RADCLIFFE A G, NEWCOMBE R G, et al . Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging[J ] . Br J Surg, 2003, 90(3):355-364. DOI: 10.1002/bjs.4034.

CHEN B B, HSU C Y, YU C W, et al . Dynamic contrast-enhanced mr imaging of advanced hepatocellular carcinoma: comparison with the liver parenchyma and correlation with the survival of patients receiving systemic therapy[J ] . Radiology, 2016, 281(2):454-464. DOI: 10.1148/radiol.201615 2659.

余加懿, 郭大静, 罗银灯, 等.磁共振动态对比增强直方图分析在前列腺癌鉴别诊断中的价值[J].第三军医大学学报, 2017, 39(22):2206-2213. DOI: 10.16016 /j.1000-5404.201708017.

YU J Y, GUO D J, LUO Y D, et al . Value of histogram analysis of quantitative parameters in dynamic contrastenhanced magnetic resonance imaging in diagnosis of prostate cancer[J ] . J Third Mil Med Univ, 2017, 39(22): 2206- 2213. DOI: 10.16016 /j.1000-5404.201708017.

KIM S Y, CHO N, PARK I A, et al . Dynamic contrast-enhanced breast MRI for evaluating residual tumor size after neoadjuvant chemotherapy[J ] . Radiology, 2018, 289(2): 327-334. DOI:10.1148/radiol.2018172868.

沈浮, 陆建平, 陈录广, 等.动态增强磁共振成像在直肠癌术前诊断中的应用研究[J].中国医学计算机成像杂志, 2016, 22(1):39-43. DOI:10.19627/j.cnki.cn31-1700/th.2016.01.009.

SHEN F, LU J P, CHEN L G, et al . Value of dynamic contrast-enhanced magnetic resonance imaging in the preoperative diagnosis of rectal cancer[J ] . Chin Comput Med Imag, 2016, 22(1):39-43. DOI:10.19627/j.cnki.cn31-1700/th.2016.01.009.

YEO D M, OH S N, JUNG C K, et al . Correlation of dynamic contrast-enhanced MRI perfusion parameters with angiogenesis and biologic aggressiveness of rectal cancer: Preliminary results[J ] . J Magn Reson Imaging, 2015, 41(2):474-480. DOI: 10.1002/jmri.24541.

CHAND M, BHANGU A, WOTHERSPOON A, et al . EMVI-positive stage Ⅱ rectal cancer has similar clinical outcomes as stage Ⅲ disease following pre-operative chemoradiotherapy[J ] . Ann Oncol, 2014, 25(4):858-863. DOI:10.1093/annonc/mdu029.

张文文, 黄刚, 周星, 等. DCE-MRI定量参数与直肠癌病理分期及分级的相关性研究[J].临床放射学杂志, 2016, 35(7):1058-1061. DOI:10.13437/j.cnki.jcr.2016.07.018.

ZHANG W W, HUANG G, ZHOU X, et al . Dynamic contrast enhanced MRIof rectal cancer: a study of the correlations between quantitative parameters and pathological stage and grades[J ] . J Clin Radiol, 2016, 35(7):1058-1061. DOI:10.13437/j.cnki.jcr.2016.07.018.

YU X P, WEN L, HOU J, et al . Discrimination of metastatic from non-metastatic mesorectal lymph nodes in rectal cancer using quantitative dynamic contrast-enhanced magnetic resonance imaging[J ] . J Huazhong Univ Sci Technol Med Sci, 2016, 36(4):594-600. DOI: 10.1007/s11596-016-1631-6.

YAO W W, ZHANG H, DING B, et al . Rectal cancer: 3D dynamic contrast-enhanced MRI; correlation with microvascular density and clinicopathological features[J ] . Radiol Med, 2011, 116(3):366-374. DOI: 10.1007/s11547-011-0628-2.

SHEN F, LU J P, CHEN L G, et al . Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in rectal cancer and its correlation with tumor differentiation[J ] . Mol Clin Oncol, 2016, 4(4): 500-506. DOI:10.3892/mco.2016.762.

TOFTS P S, BRIX G, BUCKLEY D L, et al . Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols[J ] . J Magn Reson Imaging, 1999, 10(3):223- 232.

DIJKHOFF R A P, MAAS M, MARTENS M H, et al . Correlation between quantitative and semiquantitati ve parameters in DCE-MRI with a blood pool agent in rectal cancer: can semiquantitative parameters be used as a surrogate for quantitative parameters?[J ] . Abdom Radiol (NY), 2017, 42(5):1342-1349. DOI: 10.1007/s00261-016-1024-0.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Factors influencing the development of low anterior resection syndrome in rectal cancer patients after ileostomy reversal

Current status and influencing factors of pelvic floor muscle training adherence in rectal cancer patients with prophylactic ostomy

Incidence, risk factor and recovery of low anterior resection syndrome following sphincter-preserving surgery for rectal cancer: a retrospective analysis of 337 cases

Retreatment for locally recurrent rectal cancer

Role of CK20 and CDX2 in evaluating D₃ lymph nodes micrometastasis

Related Author

SUN Wei

DENG Xiaolian

HUANG Jinqiong

WANG Zhi

WU Wenhao

LUO Ziyan

PI Hongying

LIU Na

Related Institution

Department of General Surgery， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of Clinical Nursing， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of General Surgery， Second Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of Gastrointestinal Colorectal and Anal Surgery， Army Medical Center of PLA/Daping Hospital of Third Military Medical University

Department of General Surgery， First Medical Center， Chinese PLA General Hospital， Beijing

⁰