Kang K A, Jang K M, Kim S H, Kang T W, Cha D I
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
Clin Radiol. 2017 Jun;72(6):473-481. doi: 10.1016/j.crad.2017.01.011. Epub 2017 Mar 1.
To assess the significant factors on rectal magnetic resonance imaging (MRI) to predict the likelihood of a diagnosis of metastasis for indeterminate hepatic lesions found at computed tomography (CT) in patients with rectal cancer.
A total of 207 patients with rectal cancer who underwent preoperative contrast-enhanced abdominopelvic CT, and rectal and liver MRI were included. Univariate analysis and multivariate logistic regression were used to evaluate the determining factors for the significance of indeterminate hepatic lesions on CT in patients with rectal cancer.
Hepatic metastases were diagnosed in 29 (20.9%) of 139 patients who had indeterminate hepatic lesions on preoperative CT obtained for rectal cancer. On univariate analysis, carcinoembryonic antigen level, N stage, mesorectal fascia (MRF) invasion, diameter of superior haemorrhoidal vein, and mesorectal vascular lesion (MVL) grade on rectal MRI (p<0.05) were associated with the possibility of metastasis for indeterminate hepatic lesions on CT. On multivariate analysis, MVL grade and MRF invasion on rectal MRI were independent factors associated with the possibility of metastasis for indeterminate hepatic lesions on CT (p<0.0005 and p=0.0066, respectively).
MVL grade and MRF invasion on rectal MRI are independent factors for estimating hepatic metastasis among indeterminate hepatic lesions on CT in patients with rectal cancer.
评估直肠癌患者计算机断层扫描（CT）发现的肝脏不确定病变在直肠磁共振成像（MRI）上预测转移诊断可能性的显著因素。
纳入207例行术前腹部盆腔增强CT、直肠及肝脏MRI检查的直肠癌患者。采用单因素分析和多因素逻辑回归分析评估直肠癌患者CT上肝脏不确定病变的决定因素。
139例直肠癌术前CT检查发现肝脏不确定病变的患者中，29例（20.9%）诊断为肝转移。单因素分析显示，癌胚抗原水平、N分期、直肠系膜筋膜（MRF）侵犯、痔上静脉直径以及直肠MRI上的直肠系膜血管病变（MVL）分级（p<0.05）与CT上肝脏不确定病变的转移可能性相关。多因素分析显示，直肠MRI上的MVL分级和MRF侵犯是与CT上肝脏不确定病变转移可能性相关的独立因素（分别为p<0.0005和p=0.0066）。
直肠MRI上的MVL分级和MRF侵犯是评估直肠癌患者CT上肝脏不确定病变肝转移的独立因素。
