Value of DCE-MRI quantitative parameters and ADC values in assessing the degree of histological differentiation and lymph node metastasis in rectal cancer
Objective To explore the value of apparent diffusion coefficient(ADC)values from 1.5T magnetic resonance dif-fusion-weighted imaging(MR-DWI)in assessing the degree of differentiation and lymph node metastasis in rectal cancer,ai-ming to provide a reference for the preoperative assessment of rectal cancer.Methods Clinical data of 96 patients with rectal cancer treated at Chang'an Hospital from October 2020 to December 2023 were collected and assigned to well-differentiated(n=21),moderately differentiated(n=57),and poorly differentiated groups(n=18)based on the degree of differentia-tion;and to lymph node metastasis group(n=43)and non-lymph node metastasis group(n=53)based on lymph node me-tastasis status.The ADC values,transfer constants(Ktrans),partial extracellular vascular extravascular space volume(Ve),and blood flow return constants(Kep)of patients with different degrees of differentiation and lymph node metastasis were compared,and ROC curves were plotted to analyze the predictive value of ADC values for the differentiation degree of rectal cancer.Results The ADC values in the poorly differentiated group were lower than those in the well-differentiated and moderately differentiated groups,and the Ktrans and Ve values were higher than those in the well-differentiated and moderate-ly differentiated groups,with statistically significant differences(P＜0.05).No significant differences were noted in Kep values among patients with different degrees of differentiation(P＞0.05).The Ktrans values in the lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group(P＜0.05).Moreover,no significant differences were found in ADC,Ve,and Kep values between the non-lymph node metastasis group and the lymph node me-tastasis group(P＞0.05).The area under curve(AUC),sensitivity,and specificity of Ktrans,Ve,and ADC values combined in predicting the differentiation degree of rectal cancer were 0.912(95％CI:0.793-0.965),93.84％,and 90.92％,re-spectively,which were significantly higher than those of single indicator detection(P＜0.05).Conclusion DCE-MRI quan-titative parameters and ADC values can reflect the degree of differentiation or lymph node metastasis of rectal cancer to some extent,and the combined detection of ADC,Ktrans,and Ve can improve the efficacy in predicting the differentiation degree of rectal cancer,providing reliable radiological evidence for preoperative assessment of rectal cancer.However,the effective-ness of ADC values in assessing whether rectal cancer has lymph node metastasis still warrants further research and valida-tion in the future.
Rectal cancerMagnetic resonance imagingDiffusion-weighted imagingApparent diffusion coefficientDegree of differentiationLymph node metastasisAssessed value
万方数据
维普
