摘要
Abstract
Objective To explore the predictive value of preoperative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters for postoperative local recurrence/metastasis of colorectal cancer(CRC).Methods A total of 82 patients with CRC who underwent radical surgery in our hospital from Janu-ary 2022 to December 2023 were retrospectively enrolled.All patients underwent preoperative DCE-MRI examination with complete data,and were followed up continuously for 1 year after surgery.According to the occurrence of local recurrence/metastasis,they were divided into the recurrence and metastasis group(18 cases)and the non-recurrence and metastasis group(64 cases).The preoperative DCE-MRI parameters including volume transfer constant(Ktrans),rate constant(Kep)and extracellular volume fraction(Ve)were com-pared between the two groups.The receiver operating characteristic(ROC)curve was used to evaluate the pre-dictive value of DCE-MRI parameters for postoperative local recurrence/metastasis of CRC.Multivariate stepwise Logistic regression analysis was performed to identify the influencing factors of postoperative local recurrence/metastasis of CRC.Results The Ktrans,Kep and Ve in the recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P<0.001).The areas under the curve(AUC)of Ktrans,Kep and Ve for predicting postoperative local recurrence/metastasis of colorectal cancer were 0.824,0.773 and 0.715,respectively(Z=9.246,8.445,8.013;all P<0.001),which were lower than that of the combined prediction(AUC=0.912).The proportions of clinical stage Ⅲ～Ⅳ,poor differentia-tion and vascular invasion in the recurrence and metastasis group were significantly higher than those in the non-recurrence and metastasis group(P<0.05).Multivariate analysis showed that clinical stage Ⅲ～Ⅳ(OR=1.914,95%CI:1.393‒2.629),vascular invasion(OR=2.309,95%CI:1.576‒3.384),Ktrans≥0.46 min(OR=2.517,95%CI:1.694‒3.739),Kep≥0.69 min(OR=2.330,95%CI:1.584‒3.428)and Ve≥0.28(OR=2.077,95%CI:1.471‒2.933)were risk factors for postoperative local recurrence/metastasis of CRC(P<0.001).Conclusion Preoperative DCE-MRI parameters(Ktrans,Kep,Ve)have certain predictive value for postoperative local recurrence/metastasis of CRC,and the combined predictive value is higher.关键词
结直肠癌/动态对比增强磁共振成像/复发/转移/预测价值Key words
Colorectal cancer/Dynamic contrast-enhanced magnetic resonance imaging/Recurrence/Metastasis/Predictive value
