DCE-MRI在胰腺神经内分泌肿瘤术前分级中的应用  

Value of dynamic contrast-enhanced MRI(DCE-MRI)in the grading of pancreatic neuroendocrine tumors

作　　者：赵娓娓 任静 印弘 宦怡 

机构地区：[1]空军军医大学西京医院放射科位,西安710032

出　　处：《放射学实践》2017年第10期1003-1007,共5页Radiologic Practice

基　　金：国家自然科学基金资助项目(81220108011)

摘　　要：目的:初步探讨动态对比增强磁共振成像(DCE-MRI)在胰腺神经内分泌瘤(pNETs)术前分级中的应用价值。方法:搜集2014年5月~2016年4月经手术病理证实的pNETs患者20例(25个病灶),其中G1期病灶14个,G2期10个,G3期1个,将G1期病灶归为G1pNETs组,G2期病灶归为G2pNETs组,由于G3期病灶仅1例暂未做入组分析。所有患者禁食禁水4h后行DCE-MRI扫描。数据被传输到Research-DCEMRI Tool诊断分析工作站,测定各定量灌注参数-转运常数(Ktrans)、速率常数(Kep)、细胞外血管外间隙百分比(Ve)及血浆容量百分比(Vp)。采用独立样本t检验分析不同级别pNETs定量灌注参数的差异,P<0.05表示差异有统计学意义。绘制定量参数的受试者工作特征曲线(ROC曲线),计算其在pNETs分级中的诊断效能。结果:不同分级pNETs的Ktrans值和Kep值分别比较,差异均有统计学意义(P=0.014和P=0.025);不同分级pNETs的Ve值和Vp值分别比较,均无统计学差异(P=0.786和P=0.522)。Ktrans、Kep值的ROC曲线下面积(AUC)分别为0.782和0.771,Ktrans取界值为0.714时其敏感度、特异度分别为70.00%、85.71%,Kep取界值为1.721时其敏感度、特异度分别为60.00%、92.86%。结论:DCE-MRI的Ktrans、Kep值可初步用于定量、无创评估pNETs分级,尤其Ktrans值在分级诊断中效能较高。Objective:To explore the value of dynamic contrast-enhanced MRI(DCE-MRI)in the grading of pancreatic neuroendocrine tumors(pNETs)before operation.Methods:20 pNETs patients(25 lesions)confirmed by pathology were recruited for the study from May 2014 to April 2015.From all of them,14 lesions were evaluated as G1(grade 1),10 lesions as G2 and 1 lesion as G3.They were divided into two groups:G1 pNETs group and G2 pNETs group.All patients underwent pancreas DCE-MRI examination.Images were transmitted to research-DCE-MRI tool workstation to calculate the quantitative parameters(Ktrans,Kep,Veand Vp).Independent sample t test was used to evaluate the differences of pancreatic quantitative parameters between different groups.P<0.05 indicated the difference was statistically significant.The receiver operating characteristic curve was also performed for evaluating the diagnostic efficacy of parameters in pNETs grading.Results:There were significant difference in Ktrans and Kepbetween G1 and G2 pNETs group(P=0.014 and P=0.025).There was no significant difference in Veand Vpbetween different groups(P=0.786 and P=0.522).When the Ktrans value was 0.714,the AUC was the largest(0.782)in pNETs grading,and meanwhile the sensitivity and specificity were70.00%,85.71% respectively.When the Kepvalue was 1.721,the AUC was the largest(0.771),and meanwhile the sensitivity and specificity were 60.00%,92.86%respectively.Conclusion:Ktrans,Kepof DCE-MRI can be applied to assess pNETs grading quantitatively and noninvasively.In particular,the diagnostic efficacy of Ktrans value is higher.

关 键 词：胰腺 神经内分泌瘤 磁共振成像 肿瘤分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学]