Objective To investigate whether apparent diffusion coefficient(ADC)and conventional MRI features are helpful in differentiating tumor deposits(TD)from metastatic lymph nodes(MLN).Methods Collection of 60 patients with a pathologically confirmed rectum adenocarcinoma from June 2018 to August 2023,who were untreated preoperatively and undergone MRI.After matching imaging and pathology results,108 nodules were included,of which 40 were TD and 68 were MLN.Measure and calculate the ADC values of the nodule.Evaluate routine MRI features of the nodules.Inde-pendent samples t-test,Mann-Whitney U-test and chi-square test were used to analyze the differences in TD and MLN nod-ules,binary logistic regression was used to analyze the independent predictive factors,and receiver operating characteristic curve(ROC)were plotted to clarify the diagnostic efficacy.Results Nodule ADCmin,primary-lesion ADCmean,nod-ule ADCmean/primary-lesion ADCmean,nodule ADCmin/primary-lesion ADCmin,short diameter/long diameter,and ves-sel crossing the nodule were statistically significant in a one-way analysis between TD and MLN groups(P＜0.05).Prima-ry-lesion ADCmean,nodule ADCmean/primary-lesion ADCmean,nodule ADCmin/primary-lesion ADCmin,and vessels crossing the nodule were statistically significant in binary logistic regression analyses(P＜0.05).ROC curve analysis showed that when the primary ADCmean was＜0.895 × 10-3mm2/s,the AUC、sensitivity and specificity of TD diagnosis were 0.668、70％and 64.7％.The diagnostic efficiency of the combined model with ADC values and the combined model with ADC values combined with blood vessel passing through the nodule was better,and the area under the curve(AUC)was 0.849 and 0.879,which were greater than the diagnostic efficiency of a single variable.Conclusion The primary lesion ADCmean,R ADCmean,R ADCmin,and vascular crossing nodules are independent predictive factors for distinguishing TD from MLN.The combined model of ADC value and the combined model of ADC value and vascular crossing nodules have higher accuracy in distinguishing the two than single indicators,and have certain value in preoperative differential di-agnosis of TD and MLN.
NETL
NSTL
万方数据
