利用体素内不相干运动扩散加权磁共振成像鉴别直肠癌中转移性与非转移性中直肠淋巴结
Discrimination between Metastatic and Nonmetastatic Mesorectal Lymph Nodes in Rectal Cancer Using Intravoxel Incoherent Motion Diffusion-weighted Magnetic Resonance Imaging.
作者信息
Yu Xiao-ping, Wen Lu, Hou Jing, Bi Feng, Hu Pingsheng, Wang Hui, Wang Wei
机构信息
Department of Radiology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China; Department of Diagnostic Radiology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China; Hunan Provincial Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital, Changsha, Hunan, China.
Department of Diagnostic Radiology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
出版信息
Acad Radiol. 2016 Apr;23(4):479-85. doi: 10.1016/j.acra.2015.12.013. Epub 2016 Feb 4.
RATIONALE AND OBJECTIVES
The aim of the study was to investigate the diagnostic value of intravoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM DWI) for discriminating nonmetastatic from metastatic mesorectal lymph nodes in rectal cancer.
MATERIALS AND METHODS
IVIM DWI was performed preoperatively on 50 patients with rectal carcinoma. The short-axis diameter, short- to long-axis diameter ratio, and IVIM-based parameter (pure diffusion coefficient [D], pseudo-diffusion coefficient [D*] and perfusion fraction [f]) values were compared between the metastatic and nonmetastatic lymph node groups.
RESULTS
The short-axis diameter; short- to long-axis diameter ratio; and D, D*, and f values for the nonmetastatic lymph node group (n = 28) were 6.446 ± 1.201 mm, 0.815 ± 0.099, 1.071 ± 0.234 × 10(-3) mm(2)/s, 15.443 ± 5.946 mm(2)/s and 0.261 ± 0.128, respectively, and were 9.045 ± 3.185 mm, 0.809 ± 0.099, 0.816 ± 0.121 × 10(-3) mm(2)/s, 11.679 ± 7.521 × 10(-3) mm(2)/s, and 0.190 ± 0.064, respectively, for the metastatic lymph node group (n = 31). The short-axis diameter for the metastatic group was significantly higher than for the nonmetastatic group (P <0.001). The metastatic group exhibited significantly lower D and D* values than the nonmetastatic group (P <0.01). The short- to long-axis diameter ratio and f values did not differ significantly between the two groups. Optimal cutoff values (area under the curve, sensitivity, and specificity) for distinguishing metastatic from nonmetastatic lymph nodes were as follows: short-axis diameter = 5.563 mm (0.783, 74.2%, 82.1%); D = 0.667 × 10(-3) mm(2)/s (0.885, 77.4%, 89.3%); and D* = 0.485 × 10(-3) mm(2)/s (0.727, 80.6%, 67.9%).
CONCLUSION
IVIM DWI is useful to differentiate between metastatic and nonmetastatic mesorectal lymph nodes in rectal cancer.
研究理由与目的
本研究旨在探讨体素内不相干运动扩散加权磁共振成像（IVIM DWI）在鉴别直肠癌中转移性与非转移性直肠系膜淋巴结方面的诊断价值。
材料与方法
对50例直肠癌患者术前行IVIM DWI检查。比较转移性和非转移性淋巴结组之间的短轴直径、短轴与长轴直径比值以及基于IVIM的参数（纯扩散系数[D]、伪扩散系数[D*]和灌注分数[f]）值。
结果
非转移性淋巴结组（n = 28）的短轴直径、短轴与长轴直径比值以及D、D和f值分别为6.446±1.201mm、0.815±0.099、1.071±0.234×10(-3)mm(2)/s、15.443±5.946mm(2)/s和0.261±0.128，转移性淋巴结组（n = 31）的上述指标分别为9.045±3.185mm、0.809±0.099、0.816±0.121×10(-3)mm(2)/s、11.679±7.521×10(-3)mm(2)/s和0.190±0.064。转移性组的短轴直径显著高于非转移性组（P <0.001）。转移性组的D和D值显著低于非转移性组（P <0.01）。两组之间的短轴与长轴直径比值和f值无显著差异。区分转移性与非转移性淋巴结的最佳截断值（曲线下面积、敏感性和特异性）如下：短轴直径 = 5.563mm（0.783，74.2%，82.1%）；D = 0.667×10(-3)mm(2)/s（0.885，77.4%，89.3%）；D* = 0.485×10(-3)mm(2)/s（0.727，80.6%，67.9%）。
结论
IVIM DWI有助于鉴别直肠癌中转移性与非转移性直肠系膜淋巴结。
Zotero 插件