术前DCE-MRI参数对结直肠癌术后局部复发/转移的预测价值OA
Predictive Value of Preoperative DCE-MRI Parameters for Postoperative Local Recurrence/Metastasis of Colorectal Cancer
目的:探讨术前动态对比增强磁共振成像(DCE-MRI)参数对结直肠癌术后局部复发/转移的预测价值.方法:回顾性纳入2022年1月至2023年12月于本院接受根治性手术治疗的结直肠癌病例82例,患者术前均接受DCE-MRI检查且数据完整,术后均连续随访1年,根据是否发生局部复发/转移分为复发转移组(18例)和非复发转移组(64例).比较2组患者术前DCE-MRI参数,包括容量转移常数(Ktrans)、速率常数(Kep)及血管外细胞外容积分数(Ve);采用受试者工作特性(ROC)曲线评估DCE-MRI参数对结直肠癌患者术后局部复发/转移的预测价值;采用多因素Logistic逐步回归分析结直肠癌患者术后局部复发/转移的影响因素.结果:复发转移组Ktrans、Kep、Ve均高于非复发转移组(P<0.001).Ktrans、Kep、Ve预测结直肠癌患者术后局部复发/转移的AUC分别为 0.824、0.773、0.715(Z=9.246、8.445、8.013,均P<0.001),低于联合预测(AUC=0.912).复发转移组临床分期Ⅲ～Ⅳ期、低分化、脉管浸润所占比例均大于非复发转移组(P<0.05).多因素分析显示,临床分期Ⅲ～Ⅳ期(OR=1.914,95%CI:1.393～2.629)、脉管浸润(OR=2.309,95%CI:1.576～3.384)、Ktrans≥0.46 min(OR=2.517,95%CI:1.694～3.739)、Kep≥0.69 min(OR=2.330,95%CI:1.584～3.428)、Ve≥0.28(OR=2.077,95%CI:1.471～2.933)是结直肠癌患者术后局部复发/转移的危险因素(P<0.001).结论:术前DCE-MRI参数Ktrans、Kep、Ve对结直肠癌患者术后局部复发/转移具有一定的预测价值,且联合预测价值更高.
Objective To explore the predictive value of preoperative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters for postoperative local recurrence/metastasis of colorectal cancer(CRC).Methods A total of 82 patients with CRC who underwent radical surgery in our hospital from Janu-ary 2022 to December 2023 were retrospectively enrolled.All patients underwent preoperative DCE-MRI examination with complete data,and were followed up continuously for 1 year after surgery.According to the occurrence of local recurrence/metastasis,they were divided into the recurrence and metastasis group(18 cases)and the non-recurrence and metastasis group(64 cases).The preoperative DCE-MRI parameters including volume transfer constant(Ktrans),rate constant(Kep)and extracellular volume fraction(Ve)were com-pared between the two groups.The receiver operating characteristic(ROC)curve was used to evaluate the pre-dictive value of DCE-MRI parameters for postoperative local recurrence/metastasis of CRC.Multivariate stepwise Logistic regression analysis was performed to identify the influencing factors of postoperative local recurrence/metastasis of CRC.Results The Ktrans,Kep and Ve in the recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P<0.001).The areas under the curve(AUC)of Ktrans,Kep and Ve for predicting postoperative local recurrence/metastasis of colorectal cancer were 0.824,0.773 and 0.715,respectively(Z=9.246,8.445,8.013;all P<0.001),which were lower than that of the combined prediction(AUC=0.912).The proportions of clinical stage Ⅲ～Ⅳ,poor differentia-tion and vascular invasion in the recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P<0.05).Multivariate analysis showed that clinical stage Ⅲ～Ⅳ(OR=1.914,95%CI:1.393‒2.629),vascular invasion(OR=2.309,95%CI:1.576‒3.384),Ktrans≥0.46 min(OR=2.517,95%CI:1.694‒3.739),Kep≥0.69 min(OR=2.330,95%CI:1.584‒3.428)and Ve≥0.28(OR=2.077,95%CI:1.471‒2.933)were risk factors for postoperative local recurrence/metastasis of CRC(P<0.001).Conclusion Preoperative DCE-MRI parameters(Ktrans,Kep,Ve)have certain predictive value for postoperative local recurrence/metastasis of CRC,and the combined predictive value is higher.
金建红;李立;胡开科;魏牛;钱伟军
开封市中心医院医学影像科(河南 开封 475000)开封市中心医院医学影像科(河南 开封 475000)开封市中心医院医学影像科(河南 开封 475000)开封市中心医院医学影像科(河南 开封 475000)开封市中心医院医学影像科(河南 开封 475000)
结直肠癌动态对比增强磁共振成像复发转移预测价值
Colorectal cancerDynamic contrast-enhanced magnetic resonance imagingRecurrenceMetastasisPredictive value
《中国肛肠病杂志》 2026 (2)
19-22,4
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