| Objects:To explore the diagnosis value of intravoxel incoherent motion?IVIM?in preoperative differentiation grading of rectal cancer.Methods:The patients information of rectal cancer were collected.Patients who underwent radical mastectomy for rectal cancer and who had not undergone any treatment or clinical treatment before operation were enrolled in this study.Pelvic MRI was performed on the patients before surgery,which includes the IVIM sequence,clean the intestine before the scan,instruct the patient to breathe quietly,perform sagittal scans on the scan,and then scan the sample obliquely transverse to the lesion.The IVIM sequence b values include 0,20,40,80,200,400,800,1000s/mm2,a total of eight b values.The IVIM sequence images were imported into the corresponding post-processing software,the appropriate ROI was delineated,and the data were analyzed to get the corresponding parameters:real diffusion coefficient?D?,perfusion related diffusion coefficient?D*?and perfusion fraction?f?ROI,whichever is the average of three measuring.ROI selection criteria:ROI Select the round or irregular shape according to the lesion range,select the central part of the rectum cancer center,try to avoid the edge of the tumor and the central necrotic area.According to the postoperative pathological results,the data were divided into three groups:high?group A1?,medium?group A2?and low?group A3?differentiation.The Statistical methods were single factor analysis of variance test?normal distribution?or Kruskal-Wallis H test?non-normal distribution?,statistically significant differences between groups using SNK-q test for in-group comparisons.Pearson correlation analysis was used to investigate the correlation between IVIM parameters and pathological grade,p<0.05 was statistically significant.Results:In this study,39 patients were included in the postoperative pathology confirmed high?A1 group?,middle?A2 group?,low?A3 group?differentiation group were 7 cases,23 cases 9 cases,A1,A2 and A3 average D value were?1.203±0.169?×10-3s/mm2,?0.944±0.153?×10-3s/mm2 and?0.734±0.103?×10-3s/mm2,the differences between the pathological grades were statistically significant,and D is negatively correlated with the degree of differentiation?r=-0.725,p=0.000?.The mean f values of A1,A2,and A3 were?0.196±0.0659?,?0.251±0.056?,and?0.310±0.061?,respectively.There was a statistically significant difference between A1 and A2?A3group.There was no statistically significant difference between A2 and A3 group,and there was a negative correlation between f and differentiation?r=0.507,p=0.001?.A1,A2,and A3 The average D*value was?9.990±2.576?×10-3s/mm2,?9.417±3.447?×10-3s/mm2,and?10.058±4.101?×10-3s/mm2,respectively.The difference was not statistically significant.Conclusions:IVIM parameter D showed statistically significant difference between rectal cancers with different degrees of differentiation,and the two were highly negatively correlated.There was a statistically significant difference in high with low?high grade of rectal cancer,there was a moderate positive correlation between them.IVIM parameters D and f can reflect the pathological grade of rectal cancer,and can reflect the degree of malignancy and invasiveness of rectal cancer to some extent. |
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