Wu Xue-Han, Que Yu-Tao, Yang Xin-Yue, Wen Zi-Qiang, Ma Yu-Ru, Zhang Zhi-Wen, Liu Quan-Meng, Fan Wen-Jie, Ding Li, Lang Yue-Jiao, Wu Yun-Zhu, Yuan Jian-Peng, Yu Shen-Ping, Liu Yi-Yan, Chen Yan
Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Korean J Radiol. 2025 May;26(5):400-410. doi: 10.3348/kjr.2024.0767. Epub 2025 Mar 21.
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (, , and ) and DWI (ADC, ADC, and ADC), were analyzed and compared between the two groups. Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all < 0.05). However, ADC values did not demonstrate significant differences (all > 0.05). Among the single quantitative parameters, had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, , and ADC improved diagnostic performance, achieving an AUC of 0.833 ( = 0.027).
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.
评估动态对比增强磁共振成像（DCE-MRI）在鉴别直肠癌肿瘤沉积物（TDs）与转移性淋巴结（MLNs）中的可行性。
对70例直肠癌患者进行回顾性分析，这些患者在2019年3月至2022年12月期间接受了术前MRI检查及后续手术，共包括168个病灶（70个TDs和98个经组织病理学证实的MLNs）。分析并比较两组TDs和MLNs的形态学特征，以及从DCE-MRI（、、和）和DWI（ADC、ADC和ADC）得出的定量参数。进行多变量二元逻辑回归和受试者操作特征（ROC）曲线分析，以评估显著的个体定量参数和组合参数在区分TDs与MLNs方面的诊断性能。
所有形态学特征，包括大小、形状、边界和信号强度，以及所有DCE-MRI参数在TDs和MLNs之间均显示出显著差异（均<0.05）。然而，ADC值未显示出显著差异（均>0.05）。在单个定量参数中，区分TDs与MLNs的诊断准确性最高，ROC曲线下面积（AUC）为0.772。纳入短轴、边界、和ADC的多变量逻辑回归模型提高了诊断性能，AUC为0.833（=0.027）。
形态学特征、DCE-MRI参数和ADC值的组合可有效辅助术前鉴别直肠癌中的TDs与MLNs。
