承德医学院附属医院放射科;天津市天津医院超声科;
目的：评估3.0T磁共振成像(MRI)技术，包括动态增强(DCE)和多b值扩散加权成像(DWI)，鉴别其在直肠癌良恶性淋巴结中的应用价值，并探讨其成像参数与直肠癌血管侵犯之间的相关性。方法：回顾性分析2021年3月至2023年3月期间医院收治的122例直肠癌患者的临床资料。所有患者均接受3.0T DCE‐MRI和多b值DWI检查，以肠镜活检或术后组织病理检查作为确诊标准，比较DCE‐MRI和多b值DWI与常规MRI在鉴别直肠癌淋巴结性质方面的诊断效能，并分析其成像参数与血管侵犯状态之间的关联。结果：在122例患者中，通过病理检查确认恶性淋巴结43例(35.25%)，良性淋巴结79例(64.75%)。DCE‐MRI和多b值DWI在诊断直肠癌淋巴结性质方面的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于常规MRI(P<0.05)。此外，血管侵犯阳性组在T分期、CEA水平、Ktrans值和Kep值方面显著高于阴性组，而ADC值则较低(P<0.05)。Logistic回归分析表明，高ADC值与血管侵犯阴性相关，而高T分期、CEA水平、Ktrans值和Kep值与血管侵犯阳性相关(P<0.05)。ROC曲线分析显示，ADC值、Ktrans值和Kep值对预测直肠癌血管侵犯具有一定价值(AUC分别为0.791、0.848、0.874)。结论：DCE‐MRI和多b值DWI在鉴别直肠癌淋巴结的良恶性方面表现出较高的诊断效能，并且这些成像参数与血管侵犯的存在密切相关。特别是，ADC值、Ktrans值和Kep值能够有效预测直肠癌患者的血管侵犯风险，为临床治疗决策提供重要的参考依据。
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基本信息:
DOI：
中图分类号:R735.37;R445.2
引用信息:
[1]冯涛,许双燕,刘洋洋等.3.0 T MRI动态增强+多b值DWI对直肠癌良恶性淋巴结的鉴别及与血管侵犯的关联性探究[J].影像科学与光化学,2025,43(01):17-22+28.
基金信息:
河北省医学科学研究课题计划（20231368）