多模态MRI参数联合临床指标对直肠癌肠周淋巴结转移的预测价值OA

Objective To investigate the predictive value of multimodal MRI parameters combined with clinical indicators for peripheral lymph node metastasis of rectal cancer.Methods A total of 162 patients pathologically diagnosed with rectal cancer in our hospital from January 2019 to May 2025 who un-derwent radical rectal resection and lymph node dissection were enrolled.Multimodal MRI parameters and clin-ical indicators were set as independent variables,while positive peripheral lymph node metastasis was set as the dependent variable.Univariate and multivariate analyses were performed to screen predictive factors for peripheral lymph node metastasis of rectal cancer,and ROC curves were plotted to analyze their predictive value.Results Among the162rectal cancer patients,84cases(51.85%)had positive peripheral lymph nodes(the peripheral lymph node-positive group).Significant statistical differences were observed between the two groups in gender,carcinoem-bryonic antigen(CEA),extramural venous invasion(EMVI),mesorectal fascia(MRF)positivity,pathological tumor stage,apparent diffusion coefficient(ADC),short diameter of lymph nodes,and volume transfer constant(Ktrans)(P<0.05).EMVI,MRFpositivity,ADC,short diameter of lymph nodes>5 mm,and Ktrans were identified as pre-dictive factors for peripheral lymph node metastasis of rectal cancer(P<0.05).The area under the curve(AUC)of EMVI,MRF positivity,ADC,short diameter of lymph nodes>5 mm,and Ktrans was 0.620,0.607,0.722,0.594,and 0.698,respectively.The combined predictive AUC of these indicators was0.835.Conclusion EMVI,MRF positivity,ADC,short diameter of lymph nodes>5 mm,and Ktrans are predictive indicators for peripheral lymph node metastasis in rectal cancer patients,and their combined diagnosis yields higher predictive value.