3.0T多模态MRI评估直肠癌T分期及新辅助治疗效果

目的 观察3.0T多模态MRI用于术前评估直肠癌T分期及新辅助治疗效果的价值。方法 回顾性分析150例直肠癌患者多模态MRI资料，包括T1WI、T2WI/弥散加权成像(DWI)、动态对比增强MRI(DCE-MRI)、体素内不相干运动DWI(IVIM-DWI),观察各序列评估直肠癌T分期及新辅助治疗效果的价值。结果 T1WI、T2WI/DWI、DCE-MRI、IVIM-DWI判断T1～T2期和T3～T4期直肠癌的敏感度、特异度及准确率差异均有统计学意义(P均<0.05);DCE-MRI和IVIM-DWI的诊断效能高于T1WI及T2WI/DWI(P均<0.05)。DCE-MRI与IVIM-DWI联合判断直肠癌T分期与病理学结果的一致性好(Kappa=0.943,P<0.05)。不同T分期直肠癌之间，容积转运常数(K^trans)、真弥散系数(D)及表观弥散系数(ADC)差异均有统计学意义(P均<0.05)。80例接受新辅助治疗，疗效良好(n=32)与不良(n=48)患者K^trans、D及ADC差异均有统计学意义(P均<...

3.0T multimodal MRI for evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer

Objective To observe the value of 3.0T multimodal MRI for preoperative evaluation of T stage and therapeutic efficacy of neoadjuvant for rectal cancer. Methods 3.0T multimodal MRI data, including T1WI, T2WI/diffusion weighted imaging (DWI), dynamic contrast enhanced MRI (DCE-MRI) and intravoxel incoherent motion DWI (IVIM-DWI) of 150 patients with rectal cancer were retrospectively analyzed, and the value of different sequences for evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer were assessed. Results The sensitivity, specificity and accuracy of T1WI, T2WI/DWI, DCE-MRI and IVIM-DWI for evaluating T1-T2 and T3-T4 stage rectal cancer were all significantly different (all P<0.05). The diagnostic efficacy of DCE-MRI and IVIM-DWI were all higher than that of T1WI and T2WI/DWI (all P<0.05). Combination evaluation of DCE-MRI and IVIM-DWI for T stage of rectal cancer had good consistency with pathological results (Kappa=0.943, P<0.05).Significant differences of volume transfer constant (K^trans), true diffusion coefficient (D) and apparent diffusion coefficient (ADC) were found among different T stage rectal cancers (all P<0.05). Totally 80 patients received neoadjuvant therapy, and significant differences of K^trans, D and ADC were noticed between patients with good (n=32) or poor efficacy (n=48) (all P<0.05). The area under the curve (AUC) of K^trans, D and ADC for evaluating therapeutic efficacy of neoadjuvant for rectal cancer was 0.774, 0.837 and 0.758, respectively, of the combination of above three was 0.929, higher than that of single indexes (all P<0.05). Conclusion Combination of 3.0T DCE-MRI and IVIM-DWI was helpful for preoperative evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer.