摘要
目的观察动态对比增强MRI(DCE-MRI)及弥散加权成像(DWI)参数预测结直肠癌微卫星不稳定(MSI)的价值。方法回顾性分析经病理证实的11例MSI(MSI组)和55例微卫星稳定(MSS,MSS组)结直肠癌患者,比较组间术前DCE-MRI参数,包括容积转移常数(K^(trans))、血管外细胞外间隙容积分数(V_(e))、血管内外回流速率常数(K_(ep))和初始强化曲线下面积(iAUC),以及DWI参数表观弥散系数(ADC)的差异。采用受试者工作特征(ROC)曲线评估各参数预测结直肠癌MSI的效能;基于诊断效能最高的DCE-MRI参数及ADC,采用多因素logistic回归建立联合模型,并评估其诊断效能。结果MSI组K^(trans)、K_(ep)、iAUC均低于MSS组(P均<0.05),ADC显著高于MSS组(P<0.001),而V_(e)与MSS组差异无统计学意义(P=0.536)。K_(ep)预测结直肠癌MSI的AUC为0.890,高于K^(trans)、iAUC及ADC(AUC=0.822、0.830、0.879,Z=3.456、3.173、3.170,P均<0.001);K_(ep)+ADC的AUC为0.970,高于单一K_(ep)及ADC(AUC=0.890、0.879,Z=6.171、3.978,P均<0.001)。结论DCE-MRI联合DWI参数可有效预测结直肠癌MSI。
Objective To investigate the value of dynamic contrast enhanced-MRI(DCE-MRI)and diffusion weighted imaging(DWI)parameters for predicting microsatellite instability(MSI)of colorectal cancer.Methods Data of 11 colorectal cancer patients with MSI(MSI group)and 55 colorectal cancer cases with microsatellite stability(MSS,MSS group)confirmed by pathology were retrospectively analyzed.Preoperative DCE-MRI parameters,including volume transfer constant(K^(trans)),extracellular extravascular volume fraction(V_(e)),rate constant(K_(ep))and initial area under the curve(iAUC)were compared between groups,so were apparent diffusion coefficient(ADC)of DWI.Receiver operating characteristics(ROC)curve was drawn to evaluate the efficacy of each parameter for predicting colorectal cancer MSI.Multivariate logistic regression was used to establish a combined model based on DCE-MRI parameters with the highest diagnostic performance and ADC,and its diagnostic efficacy was evaluated.Results K^(trans),K_(ep)and iAUC of MSI group were lower than those of MSS group(all P<0.05),ADC of MSI group was significantly higher than that of MSS group(P<0.001),while V_(e) were not significantly different between groups(P=0.536).AUC of K_(ep)for predicting colorectal cancer MSI was 0.890,higher than those of K^(trans),iAUC and ADC(AUC=0.822,0.830,0.879,Z=3.456,3.173,3.170,all P<0.001),of K_(ep)+ADC was 0.970,higher than that of K_(ep)and ADC alone(AUC=0.890,0.879,Z=6.171,3.978,both P<0.001).Conclusion DCE-MRI combined with DWI parameters could be used to effectively predict MSI of colorectal cancer.
作者
马文婷
朱袁慧
魏照坤
王莉莉
MA Wenting;ZHU Yuanhui;WEI Zhaokun;WANG Lili(Department of Radiology,Gansu Provincial Hospital,Lanzhou 730000,China)
出处
《中国医学影像技术》
CSCD
北大核心
2023年第10期1526-1530,共5页
Chinese Journal of Medical Imaging Technology
基金
甘肃省青年科技基金计划(20JR5RA143)。
关键词
结直肠肿瘤
磁共振成像
微卫星不稳定性
colorectal neoplasms
magnetic resonance imaging
microsatellite instability
