基于体素内不相干运动DWI在食管癌诊断中的应用价值  

The Value of DWI Based on Intra Voxel Incoherent Motion in Diagnosing Esophageal Cancer

作　　者：李筱倩[1] 秦健[1] 杨慧[1] 张敏凤[1] 朱建忠[1] 李长勤[1] 

机构地区：[1]泰山医学院附属医院影像中心,泰安271000

出　　处：《临床放射学杂志》2017年第4期505-509,共5页Journal of Clinical Radiology

摘　　要：目的探讨多b值双指数模型DWI对食管癌的诊断价值。方法 35例经病理证实的食管癌患者纳入研究,所有患者均行多b值DWI检查(11个b值:0、10、20、30、50、100、200、400、800、1200、1500 s/mm^2)。获得双指数模型参数:标准表观扩散系数(ADC_(st))、慢速表观扩散系数(ADC_(slow))、快速表观扩散系数(ADC_(fast))、快速扩散成分所占比例(F_(fast))。绘制ROC曲线,比较各参数对食管癌病变与正常食管管壁的诊断效能。结果病变组的ADC_(slow)、ADC_(fast)、ADC_(st)、F_(fast)值分别为(1.18±0.18)×10^(-3)mm^2/s、(10.63±4.87)×10^(-3)mm^2/s、(2.30±0.46)×10^(-3)mm^2/s、0.42±0.15;正常组的ADC_(slow)、ADC_(fast)、ADC_(st)、F_(fast)值分别为(1.24±0.25)×10^(-3)mm^2/s、(10.36±3.71)×10^(-3)mm^2/s、(2.88±0.57)×10^(-3)mm^2/s、0.59±0.12。两组间F_(fast)值差异具有统计学意义。ROC曲线分析发现F_(fast)值鉴别两者的最佳诊断界点为0.47,敏感性为88.1%,特异性为56.9%,曲线下面积为0.784。结论多b值双指数衰减模型能够有效评价食管癌血流灌注与扩散变化信息,F值对食管癌的诊断效能较高。Objective To investigate the value of multi-b-value DWI based on IntraVoxel Incoherent Motion in diagnosing esophageal cancer. Methods 35 patients with esophageal cancer confirmed by pathology were included in the study, and all patients underwent 3.0 T MRI scan using multi-b-value sequence （ 11 b values：0,10,20,30,50,100,200,400, 800,1200,1500 s/mm^2 ）. The IVIM Biexponential model parameters （ standard apparent diffusion coefficient, ADCst, ; slow apparent diffusion coefficient,ADCslow ;fast apparent diffusion coefficient, ADCfast;fraction of ADCfast, Ffast） were obtained. Using the ROC curve to evaluate the diagnostic efficacy of each parameter, and the area under the curve AUC and the best diagnostic threshold were calculated. Results ADCslow, ADCfast、 ADCst, Ffast of the lesions were （1.18±0. 18 ）×10^-3 mm^2/s, （ 10.63±4.87）×10^-3 mm2/s, （ 2.30±0.46 ）×10^-3 mm2/s,0. 42±0. 15 respectively, and ADCslow, ADCfast, ADCst,Ffast of the normal areas were （1.24±0.25）10 - 3mm^2/s,（10. 36 ＋3.71）×10^-3 mm^2/s, （2.88±0.57）×10^-3 mm2/s,0.59±0. 12 respectively. The difference of Ffast, was statistically significant （ P 〈 0.05 ）. The diagnostic cutoff value was 0.47, the sensitivity and the specificity was 88.1%, 56.9% respectively. The calculated area （AUC）of Ffast, was 0. 784. Conclusion Multi-b-value DWI based on IntraVoxel Incoherent Motion is helpful in diagnosing of esophageal cancer. Ffast is the most valuable parameter for esophageal cancer.

关 键 词：食管癌 扩散加权成像 双指数模型 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.1[医药卫生—诊断学]