对比分析扩散峰度成像和体素内不相干运动成像诊断宫颈鳞癌与腺癌及其分级
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摘要
目的对比分析扩散峰度成像(DKI)和体素内不相干运动成像(IVIM)诊断宫颈鳞癌与腺癌及其分级的价值。方法回顾性分析60例宫颈癌[鳞癌组(n=38),腺癌组(n=22)]患者的DKI和IVIM资料,测量宫颈癌组织的平均扩散峰度(MK)、平均扩散系数(MD)、慢速扩散系数(D)、快速扩散系数(D~*)和灌注分数(f)值。分别比较宫颈鳞癌组和腺癌组及不同分级亚组间各参数值的差异,采用ROC曲线评价各参数的诊断效能,以Spearman相关性分析评价各参数与病理分级的相关性。结果宫颈鳞癌组MK值高于腺癌组,MD、D、D~*和f值低于腺癌组(P均<0.05)。2组MK、MD和D值在不同分级亚组间差异均有统计学意义(P均<0.05);腺癌组中f值在不同分级亚组间差异有统计学意义(P均<0.05)。MK值鉴别诊断宫颈鳞癌与腺癌及不同病理分级的AUC最高;除D*外,其余参数与宫颈鳞癌和腺癌病理分级均存在相关性(P均<0.05)。结论与IVIM相比,DKI可更有效地诊断宫颈鳞癌与腺癌,并评估其病理分级。
Objective To compare the value of diffusion kurtosis imaging(DKI)and intravoxel incoherent motion(IVIM)in evaluation of histological classification and grading of cervical squamous cell carcinoma and cervical adenocarcinoma.Methods DKI and IVIM data of 60 patients with cervical cancer were retrospectively analyzed,and MK,MD,D,D~* and f values were measured.The differences of the parameters between cervical squamous cell carcinoma group(n=38)and cervical adenocarcinoma group(n=22)were analyzed,as well as among different graded subgroups.The diagnostic efficiency of each parameter was evaluated with ROC curve,the correlations between the parameters and pathological grades were analyzed using Spearman method.Results MK of cervical squamous cell carcinoma group was higher than that of cervical adenocarcinoma group,while MD,D,D*and f were lower than those of cervical adenocarcinoma group(all P<0.05).In both groups,the differences of MK,MD and D were statistically significant among different subgroups(all P <0.05),while in cervical adenocarcinoma group,the differences of f were also statistically significant among different subgroups(all P <0.05).MK had the highest AUC in diagnosing cervical squamous cell carcinoma and adenocarcinoma.Except for D*,there was correlation between other parameters and pathological grade(all P<0.05).Conclusion Compared with IVIM,DKI can more effectively evaluate cervical squamous cell carcinoma and cervical adenocarcinoma and their pathological grading.
Objective To compare the value of diffusion kurtosis imaging(DKI)and intravoxel incoherent motion(IVIM)in evaluation of histological classification and grading of cervical squamous cell carcinoma and cervical adenocarcinoma.Methods DKI and IVIM data of 60 patients with cervical cancer were retrospectively analyzed,and MK,MD,D,D~* and f values were measured.The differences of the parameters between cervical squamous cell carcinoma group(n=38)and cervical adenocarcinoma group(n=22)were analyzed,as well as among different graded subgroups.The diagnostic efficiency of each parameter was evaluated with ROC curve,the correlations between the parameters and pathological grades were analyzed using Spearman method.Results MK of cervical squamous cell carcinoma group was higher than that of cervical adenocarcinoma group,while MD,D,D*and f were lower than those of cervical adenocarcinoma group(all P<0.05).In both groups,the differences of MK,MD and D were statistically significant among different subgroups(all P <0.05),while in cervical adenocarcinoma group,the differences of f were also statistically significant among different subgroups(all P <0.05).MK had the highest AUC in diagnosing cervical squamous cell carcinoma and adenocarcinoma.Except for D*,there was correlation between other parameters and pathological grade(all P<0.05).Conclusion Compared with IVIM,DKI can more effectively evaluate cervical squamous cell carcinoma and cervical adenocarcinoma and their pathological grading.
引文
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[3]Wang P,Thapa D,Wu G,et al.A study on diffusion and kurtosis features of cervical cancer based on non-Gaussian diffusion weighted model.Magn Reson Imaging,2018,47:60-66.
[4]邹雪雪,秦东京,姜兴岳,等.DCE-MRI联合IVIM-DWI鉴别诊断乳腺良恶性病变.中国医学影像技术,2016,32(4):534-538.
[5]Lee HJ,Rha SY,Chung YE,et al.Tumor perfusion-related parameter of diffusion-weighted magnetic resonance imaging:Correlation with histological microvessel density.Magn Reson Med,2014,71(4):1554-1558.
[6]Patel J,Sigmund EE,Rusinek H,et al.Diagnosis of cirrhosis with intravoxel incoherent motion diffusion MRI and dynamic contrast-enhanced MRI alone and in combination:Preliminary experience.J Magn Reson Imaging,2010,31(3):589-600.
[7]Koenigkam Santos M,Muley T,Warth A,et al.Morphological computed tomography features of surgically resectable pulmonary squamous cell carcinomas:Impact on prognosis and comparison with adenocarcinomas.Eur J Radiol,2014,83(7):1275-1281.
[8]叶晓华,周诚,王宏,等.MR体素内不相干运动成像评价宫颈癌组织学特征的初步研究.临床放射学杂志,2016,35(7):1048-1052.
[9]Jiang R,Jiang J,Zhao L,et al.Diffusion kurtosis imaging can efficiently assess the glioma grade and cellular proliferation.Oncotarget,2015,6(39):42380-42393.
[10]Lee EY,Yu X,Chu MM,et al.Perfusion and diffusion characteristics of cervical cancer based on intraxovel incoherent motion MR imaging-apilot study.Eur Radiol,2014,24(7):1506-1513.
[11]Federau C,Hagmann P,Maeder P,et al.Dependence of brain intravoxel incoherent motion perfusion parameters on the cardiac cycle.PLoS One,2013,8(8):e72856.