动态增强磁共振成像评价直肠癌壁外血管侵犯的价值

张海平; 刘欣杰; 余翔玲; 郭大静; 何晓静; 周君; 刘洋洋

doi:10.16016/j.1000-5404.201811205

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动态增强磁共振成像评价直肠癌壁外血管侵犯的价值

临床医学 | 更新时间：2026-01-09

- 动态增强磁共振成像评价直肠癌壁外血管侵犯的价值
- Value of dynamic contrast enhanced magnetic resonance imaging in evaluation of extramural venous invasion in rectal cancer
- 第三军医大学学报 2019年41卷第11期页码：1070-1076
- 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：
  
  [刘欣杰，E-mail：13996279816@163.comLIU Xinjie, E-mail: 13996279816@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201811205
  中图分类号： R445.2;R73-37;R735.37
- 收稿：2018-11-28，
  
  修回：2019-01-14，
  
  纸质出版：2019-06-15
- 稿件说明：
移动端阅览
张海平, 刘欣杰, 余翔玲, 等. 动态增强磁共振成像评价直肠癌壁外血管侵犯的价值[J]. 第三军医大学学报, 2019,41(11):1070-1076.

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.
张海平, 刘欣杰, 余翔玲, 等. 动态增强磁共振成像评价直肠癌壁外血管侵犯的价值[J]. 第三军医大学学报, 2019,41(11):1070-1076. DOI： 10.16016/j.1000-5404.201811205.

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

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