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酰胺质子转移成像在直肠癌淋巴结转移评估中的应用
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Abstract:
目的：探究磁共振(MRI, Magnetic Resonance Imaging)中酰胺质子转移成像序列(APT, Amide Proton Transfer Imaging)对评估直肠癌淋巴结转移的价值。方法：我们选取了2022年3月至2023年10月安徽医科大学第二附属医院普外科收治的直肠癌患者40例，术后病理均明确为直肠癌，其中出现淋巴结转移的18例，无淋巴结转移的22例。所有患者在术前均行盆腔磁共振成像检查，且在检查序列中增加APT序列扫描，并获得APT值，同时收集患者一般临床资料，采用单因素分析及多因素logistic回归分析直肠癌淋巴结转移的相关危险因素。结果：单因素分析结果提示：直肠癌淋巴结转移与直肠癌患者的CEA值，肿瘤距肛门距离、肿瘤直径、肿瘤的T分期及APT信号强度有关(P < 0.05)。多因素分析结果提示：肿瘤距肛门距离、肿瘤的T分期与APT信号强度为直肠癌出现淋巴结转移的独立影响因素(P < 0.05)。结论：APT信号强度是判断直肠癌淋巴结转移的独立危险因素，APT信号强度越高，提示淋巴结转移可能越大。
Objective: To investigate the value of amide proton transfer imaging (APT) in magnetic resonance imaging (MRI) for the diagnosis of rectal cancer lymph node metastasis. Methods: We selected 40 patients with rectal cancer admitted to the Department of General Surgery of the Second Affiliated Hospital of Anhui Medical University from March 2022 to October 2023, and all of them were clearly identified as rectal cancer by postoperative pathology, among which 18 cases showed lymph node metastasis and 22 cases had no lymph node metastasis. All patients underwent preoperative pelvic magnetic resonance imaging, and APT sequence scanning was added to the examination sequence, and APT values were obtained. General clinical data of the patients were collected at the same time, and the risk factors related to lymph node metastasis of rectal cancer were analyzed by unifactorial analysis and multifactorial logistic regression. Results: The results of unifactorial analysis: rectal cancer lymph node metastasis was related to the CEA value of rectal cancer patients, tumor distance from the anus, tumor diameter, T stage of the tumor and APT signal intensity (P < 0.05). The results of multifactorial analysis suggested that tumor distance from the anus, T stage of the tumor and APT signal intensity were independent influencing factors for the appearance of lymph node me-tastasis in rectal cancer (P < 0.05). Conclusion: APT signal intensity is an independent risk factor for determining lymph node metastasis in rectal cancer, and the higher APT signal intensity suggests that lymph node metastasis may be greater.
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