多参数MRI方法在经过新辅助疗法的局部晚期直肠癌患者中确定了病理完整反应
Yudie Pan1, Shuxing Wang2, Xiaowen Liu2
1Department of Radiology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China.
BMC medical imaging
|February 9, 2026
概括
多参数核磁共振 (MPmMRI) 显著改善了在经过新辅助疗法 (NAT) 后在局部晚期直肠癌 (LARC) 患者中检测病理完整反应 (pCR) 的检测. 这种先进的成像技术有助于手术决策,并支持器官保存策略.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 准确评估治疗反应对于管理局部晚期直肠癌 (LARC) 至关重要.
- 新辅助疗法 (NAT) 是LARC的标准,但预测病理完整反应 (pCR) 仍然具有挑战性.
- 磁共振成像 (MRI) 用于评估治疗反应,但其疗效可以提高.
研究的目的:
- 评估不同MRI技术的诊断性能,以确定LARC患者在NAT后的pCR.
- 为了比较基于MRI的瘤回归分级 (TRG) 方法,包括单独的T2加权成像 (T2WI),双参数MRI (BPmMRI) 和多参数MRI (MPmMRI).
主要方法:
- 对152名LARC患者的回顾性分析,这些患者接受了NAT治疗,随后进行了手术.
- 使用MRI评估NAT反应,包括T2WI-only TRG (mrTRG),BPmMRI (T2WI + DWI) 和MPmMRI (T2WI + DWI + CE-T1WI).使用MRI评估NAT反应,包括T2WI-only TRG (mrTRG),BPmMRI (T2WI + DWI) 和MPmMRI (T2WI + DWI + CE-T1WI).
- 使用ROC曲线分析 (AUC),PPV,NPV,灵敏度和特异性的诊断疗效的比较.
主要成果:
- MPmMRI显示了pCR检测的最高AUC (0.891),超过了BPmMRI (0.840) 和mrTRG (0.729).
- 与mrTRG相比,MPmMRI显示AUC和灵敏度显著更高 (p < 0.01).
- 根据组织病理学分析,在17.8%的患者中实现了pCR.
结论:
- 将扩散权重成像 (DWI) 和对比度增强的T1权重成像 (CE-T1WI) 纳入MRI显著改善了在LARC中NAT后的pCR诊断.
- 增强的MRI准确度有助于临床医生在治疗决策和患者咨询中使用"观看和等待"策略.
- 改进的pCR识别有助于器官的保存,并可能避免不必要的手术.
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