| BackgroundRectal cancer is one of the most common types of malignant cancer with high incidence and mortality in digestive system,currently,the clinical treatment of rectal cancer patients with individual methods,Accurate assessment preoperative staging and malignancy of rectal cancer is very important for the selection of the best treatment regimen,curative effect evaluation and prognosis of treatment.At present,the conventional medical imaging methods can analysis rectal lesions from morphological,that can not evaluate internal microenvironment of rectal lesions with functional methods.IVIM-DWI is one of noninvasive functional imaging methods of magnetic resonance imaging,which can separate and quantify the diffusion and perfusion information of tissue that can be used to make a diagnosis of the lesion,through the quantitative analysis of specific parameters.In recent years,IVIM-DWI is one of hot spots in the clinical application of functional and molecular imaging.ObjectiveTo investigate the value of IVIM-DWI quantitative parameters in T stage,differentiati-on and identification of metastatic lymph nodes of rectal adenocarcinoma.MethodsRectal adenocarcinoma patients confirmed by colonoscopy underwent 3.0 T MRI exa-mination,their clinicopathologic data were collected.All original data were send to GE ADW 4.5 workstation,the MADC softwere of the workstation was used to calculate the value of standard ADC(sADC),D,D*and f of lumps and lymph nodes.All parameters of various T stages and differentiated degree were compared by ANOVA and comparison bet-ween the two groups by LSD.Bland-Altman analytical method was used to test the consist-ency of the parameters within the observers and between the observers.All parameters of metastatic and non-metastatic lymph nodes were compared by Mann-Whitney U test and ROC curves were plotted and analyzed for statistically significant parameter data.Results(1)The sADC and D value in various T stages and degrees of differentiation were all statistically significant,for rectal adenocarcinoma of T2-T4,the value of sADC were(1.157 ± 0.150)×10-3 mm2/s,(0.913 ± 0.097)×10-3 mm2/s,(0.801 ± 0.051)×10-3 mm2/s,The value of D were(0.701 ± 0.098)× 10-3 mm2/s,(0.601 ± 0.091)× 10-3 mm2/s,(0.539 ± 0.038)× 10-3 mm2/s,the value of sADC in high,medium and low differentation were(1.158 ± 0.110)×10-3 mm2/s,(0.970 ±0.151)×10-3 mm2/s,(0.812 ±0.071)×10-3 mm2/s,respectively,the value of D in high,medium and low differentation were(0.784 ±0.034)× 10-3mm2/s,(0.631 ± 0.079)× 10-3mm2/s,(0.613 ± 0.099)× 10-3mm2/s,D*and f value were no significant difference.(2)For rectal adenocarcinoma,the sADC,D,D*,f values of metastatic lymph nodes were less than non-metastatic lymph nodes,The sADC,D,f values between metastatic and non-metastatic lymph nodes were all statistically significant.D*was no significant differe-nce between metastatic and non-metastatic lymph nodes(P=0.781).Non-metastatic lymph nodes as reference,the ROC curves were plotted on the sADC,D,f values of metastatic lymph nodes,and the area under the curve were 0.806,0.870 and 0.745,respectively.The D value had the greatest diagnostic efficacy.When the threshold of D was 0.508 × 10-3 mm/s,the sensitivity and specificity of the diagnosis were 78.38%and 85.25%,respectively.ConclusionQuantitative parameters sADC,D,D*and f of IVIM-DWI could reflect the T stages,differentiation degree and pathophysiological state of lymph nodes of rectal adenocarcino-ma to a certain extent,Parameters D in diagnosis of T stages,differentiation degree and identification metastatic lymph nodes of rectal adenocarcinoma have the greatest diagnost-ic efficiency,IVIM-DWI can serve as a complement sequence for conventional MRI seq-uences,which can provide more information to choose the individual methods. |
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