喉及下咽鳞癌磁共振体素内不相干运动成像特征初步观察  

Preliminary study on intravoxel incoherent motion （IVIM） imaging in laryngeal and hypopharyngeal squamous cell carcinoma

作　　者：郭炜[1] 罗德红[1] 林蒙[1] 李琳[1] 赵燕风[1] 杨亮[1] 周纯武[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院影像诊断科,100021

出　　处：《中华医学杂志》2016年第15期1160-1163,共4页National Medical Journal of China

摘　　要：目的 探讨喉及下咽鳞癌磁共振（MR）体素内不相干运动扩散加权成像（IVIM）特征.方法 回顾性分析2014年11月-2015年8月中国医学科学院肿瘤医院诊治并经病理证实的32例喉及下咽鳞癌患者,治疗前行MR扩散加权成像IVIM序列检查.IVIM序列扫描采用12个b值（0、10、20、30、50、70、100、150、200、400、800和1 000 s/mm2）,所得原始数据经双指数模型处理,生成对应参数图.分别测量原发癌、正常咽壁及不同病理分级原发癌的纯扩散系数D值、伪扩散系数D＊值及灌注分数f值,比较其差异.结果 D、f值在喉与下咽鳞癌组间差异无统计学意义（P =0.903,0.223）,D＊值在组间差异有统计学意义（P=o.028）.原发癌D、D＊及f值分别为（0.84 ±0.22）×10-3 mm2/s、（65.71±19.66）×10-3 mm2/s和45％±14％;正常咽壁组织D、D＊及f值分别为（1.48±1.04）×10-3 mm2/s、（37.85±14.04）×10-3 mm2/s和36％±12％.原发癌与正常咽壁D、D＊及f值比较,D值低于正常咽壁（P=0.001）,D＊、f值高于正常咽壁（P=0.000、0.006）.受试者工作特征（ROC）曲线分析D值诊断效能最佳,以D =0.949×10-3 mm2/s为阈值,鉴别原发癌与正常咽壁,敏感度、特异度和准确度分别为91.2％、88.2％和92.5％.不同病理分级原发癌比较,D、f值在各组间差异均无统计学意义（均P ＞0.05）,D＊值差异有统计学意义（P=0.001）.D＊值在高分化组与中、低分化组间比较差异均有统计学意义（均P ＜0.05）,在中分化与低分化组间差异无统计学意义（P＞0.05）.结论 喉及下咽鳞癌与正常咽壁IVIM参数差异有统计学意义,D值的诊断价值最高.D＊值在不同病理分级的喉及下咽鳞癌中差异有统计学意义,可以在一定程度上反映肿瘤的分化程度.Objective To evaluate the diagnostic performance of bi-exponential modeling of intravoxel incoherent motion （IVIM） imaging for laryngeal and hypopharyngeal carcinoma.Methods A total of 32 patients with pathologically proven laryngeal and hypopharyngeal squamous cell carcinoma were included in this study from November 2014 to August 2015.All patients underwent IVIM-DWI by using twelve b values （0,10,20,30,50,70,100,150,200,400,800 and 1 000 s/mm2）.Using the IVIM approach,D,D＊ and f values were extracted using a bi-exponential fit.These quantitative parameters of primary carcinoma and normal pharyngeal tissue were compared.Statistical methods were used to assess differences between the tumor and normal pharyngeal tissue.Results There were no significant differences of D （P =0.903） and f （P =0.223） values observed among laryngeal carcinoma and hypopharyngeal carcinoma,and D＊ value was significantly different among the two groups （P =0.028）.The values of D,D＊,and f for primary carcinoma were （0.84 ±0.22） × 10-3 mm2/s,（65.71 ± 19.66） × 10-3 mm2/s,and 45％ ± 14％,respectively;for normal pharyngeal tissue were （1.48 ± 1.04） × 10-3 mm2/s,（37.85 ± 14.04） × 10-3 mm2/s,and 36％ ± 12％,respectively （P =0.001,0.000,and 0.006,respectively）.Setting D value 0.949 × 10-3 mm2/s was threshold to distinguish abnormal and normal tissues,the sensitivity,specificity and accuracy were 91.2％,88.2％ and 92.5％,respectively.There was no statistically significant difference of D and f values （both P ＞ 0.05） in different pathological grades of primary carcinoma,and there was statistically significant difference in D＊ values found among the different pathological grades of primary carcinoma （P=0.001）.There were statistically significant differences in D＊ values between the well differentiated group and the other two group （both P ＜ 0.05）,and there was no statistically significant difference between the moderately differentiated group and poorly differentiated

关 键 词：磁共振成像 喉肿瘤 下咽肿瘤 体素内不相干运动扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.6[医药卫生—诊断学]