动态增强磁共振成像与直肠癌分化程度的相关性研究

摘要

目的：探讨直肠癌的动态增强磁共振成像（DCE-MRI）的各参数指标与直肠癌分化程度的相关性。方法：40例经病例证实的直肠癌患者进行 DCE-MRI 成像，应用 Tofts 模型后处理得到感兴趣区的微循环参数 Ktrans 、Kep 、Ve 及iAUC 值，与术后病理分化程度进行 Kruskal-Wallis 秩和检验，Pearson 秩相关性分析。同时选取15例未患直肠癌的对照组，将其与患者组的动态增强参数进行对照。结果：患者组病灶的 Ktrans 值、Kep 值、Ve 值、iAUC 值均高于对照组，2组间差异有统计学意义（P ＜0．05）。直肠癌病灶的时间-信号强度曲线表现为流出型。40例直肠癌术后病理结果 G1级6例，G2级21例，G3级13例。不同病理 G 分级组间 Ktrans 值、Kep 值、iAUC 值差异有统计学意义（P 均＜0．05）；Ktrans 值、iAUC 值与 G 分级有相关性（P ＜0．05）。结论：磁共振动态增强成像能反映直肠癌的微循环差异，其参数指标在一定程度上与直肠癌分化程度有相关性。%Objective:To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in evaluation of rectal cancer,and explore the correlation between the parameters and rectal cancer pathologicaldifferentiation.Methods:4 0 patients with histologically proven rectal cancer were studied by preoperative DCE-MRI.All ofthe data were transferred to workstation for analyzing the microcirculation parameters of region of interest by using theTofts model,which included Ktrans ,Kep ,Ve and iAUC,then they were compared with postoperative pathology,the resultswere statistically analyzed.1 5 patients without rectal cancer were selected and compared with the cancer group.Results:TheKtrans ,Kep ,Ve,iAUC of the rectal cancer were higher than those of the normal group (P <0.05 ).The time-signal intensitycurve belonged to the outflow type.The postoperative pathological results:6 cases were G1,21 cases were G2,1 3 cases wereG3 .The Ktrans and iAUC had a positive correlation with the degree of pathological differentiation,P <0.05 .Conclusion:Theparameters of DCE-MRI can reflect the difference of blood supply in different tissues of the rectal cancer and have certaineffect in the evaluation of the differentiation degree.