【摘要】 目的：探讨弥散峰度成像（DKI）、体素内不相干运动（IVIM）参数及临床指标与直肠腺癌病理特征的相关性。方法：前瞻性收集75例经术后病理证实为直肠腺癌患者临床影像资料，并根据病理结果分组。采用独立样本t检验、秩和检验及卡方检验比较组间差异，使用Spearman相关性分析比较DKI、IVIM及临床指标与直肠腺癌病理结果的相关性。结果：病理结果显示，T_1-2期21例，T_3-4期54例；N₀期41例，N_1-2期34例；G_1-2期55例，G₃期20例；有脉管侵犯24例，无脉管侵犯51例；有神经侵犯24例，无神经侵犯51例；T分期中平均峰度（MK）值、灌注分数（f）值及癌胚抗原（CEA）的组间差异有统计学意义（P<0.05），三者与T分期的相关系数（r_s）分别为0.256、0.244和0.335;N分期中MK值、平均弥散率（MD）值、真性弥散系数（D）值、CEA及糖类抗原（CA）19-9组间差异有统计学意义，它们与N分期的r_s分别为0.525、-0.439、-0.367、0.363和0.251；脉管侵犯组间CEA及CA125差异有统计学意义，两者与脉管侵犯的r_s分别为0.277和0.369；神经侵犯组间D值差异有统计学意义，神经侵犯与D值的r_s为-0.242。结论：DKI和IVIM定量参数及临床指标与直肠腺癌的多种病理特征存在相关性，这些参数对直肠腺癌的诊断及治疗具有重要的指导意义。更多还原

【Abstract】 Purpose: To explore the correlation between quantitative parameters of diffusion kurtosis imaging（DKI）, intravoxel incoherent motion（IVIM）, clinical indicators, and pathological characteristics of rectal adenocarcinoma. Methods: Clinical and imaging data of 75 patients with pathologically confirmed rectal adenocarcinoma were prospectively collected. The patients were categorized based on pathological results. Independent samples t-test, rank sum test, and chi-square test were used to compare differences between groups. Spearman correlation analysis was applied to evaluate the correlation between DKI parameters, IVIM parameters, clinical indicators, and pathological characteristics of rectal adenocarcinoma. Results: Pathological results showed the following distributions: 21 cases in T_1-2 stage and 54 cases in T_3-4 stage; 41 cases in N₀ stage and 34 cases in N_1-2 stage; 55 cases in G_1-2 stage and 20 cases in G₃ stage; 24 cases with vascular invasion and 51 cases without; 24 cases with nerve invasion and 51 cases without. For T staging, there were statistically significant differences in mean kurtosis（MK） of DKI, perfusion fraction（f） of IVIM, and carcinoembryonic antigen（CEA） levels between groups（all P<0.05）, with Spearman correlation coefficients（r_s） of 0.256, 0.244, and 0.335, respectively. For N staging, statistically significant differences were observed in MK, mean diffusivity（MD）, diffusion coefficient（D）, CEA, and carbohydrate antigen 19-9（CA19-9） between groups（all P<0.05）, with r_s values of 0.525,-0.439,-0.367, 0.363, and 0.251, respectively. Regarding vascular invasion, CEA and carbohydrate antigen 125（CA125） levels showed statistically significant differences between the invasive and non-invasive groups（all P<0.05）, with r_s values of 0.277 and 0.369, respectively. For nerve invasion, there was a statistically significant differences in D value between the invasive and non-invasive groups（P<0.05）, with an r_s value of-0.242. Conclusion: DKI and IVIM quantitative parameters, along with clinical indicators, are correlated with various pathological features of rectal adenocarcinoma. These parameters hold significant importance for the diagnosis and treatment of rectal adenocarcinoma.更多还原