磁共振DKI成像预测直肠癌TN分期、分化和脉管侵犯的应用价值

目的：探讨磁共振DKI成像技术预测直肠癌TN分期、分化和脉管侵犯的应用价值。方法：选取2017年至2019年南通市肿瘤医院住院的43例直肠癌患者,行常规MRI及DKI扫描,经后处理软件获得DKI参数,并于1周内行病灶切除及送病理检查。结果：随着T分期增加,MK值升高,各参数在各组患者间差异均有统计学意义（P<0.05）,MD值组间差异无统计学意义。直肠腺癌病理分化程度越低,MD值越低,MK值越高,各组患者总体差异均有统计学意义（P<0.05）。有脉管侵犯的病例MK值较无脉管侵犯者更大,两者间差异有统计学意义（P<0.05）,AUC为0.772,灵敏度为81.0%,特异度为68.7%。MK及MD值在有无淋巴结转移的直肠癌组间差异有统计学意义（P<0.05）。结论：MK值可辅助诊断直肠癌T分期情况;MK联合MD值可预测直肠癌病理分化程度。MK值可预测直肠癌周围脉管有无侵犯;MK联合MD可辅助诊断直肠癌是否发生淋巴结转移,具有更好的诊断效能。

Application value of magnetic resonance diffusion kurtosis imaging in predicting TN stage, differentiation and vascular invasion of rectal cancer

Objective:To explore the value of magnetic resonance diffusion kurtosis imaging (DKI) in the prediction of TN staging, differentiation and vascular invasion of rectal cancer.Methods:Forty-three patients with rectal cancer hospitalized in our hospital from 2017 to 2019 underwent routine MRI and DKI were selected, and DKI parameters were obtained by post-processing software. The lesions were resected and sent for pathological examination within one week.Results:With the increase of T staging, the MK value increased, and the difference of each parameter in each group of patients was statistically significant (P<0.05), and the MD value was not significantly different. The lower the degree of pathological differentiation of rectal adenocarcinoma, the lower the MD value, and the higher the MK value. The overall differences in each group of patients were statistically significant (P<0.05). The MK value of cases with vascular invasion was greater than that without vascular invasion, and the difference between the two was statistically significant (P<0.05), with an AUC of 0.772, a sensitivity of 81.0%, and a specificity of 68.7%; there was no statistical difference in MD values. MK and MD values are statistically significant between the two groups of rectal cancer with lymph node metastasis (P<0.05).Conclusions:MK value can assist in the diagnosis of rectal cancer T staging. MK and MD values can predict the degree of pathological differentiation of rectal cancer. The MK value can be used to predict whether there is vascular invasion around rectal cancer. MK and MD can assist in the diagnosis of lymph node metastasis in rectal cancer, and the combination of MK and MD has better diagnostic efficiency.