直肠癌体素内不相干运动MRI参数的一致性和可重复性  

Repeatability and consistency of intravoxel incoherent motion parameters of rectal cancers

作　　者：卢宝兰 肖晓娟[2] 杨心悦[1] 陈琰 文自强 余深平[1] LU Baolan;XIAO Xiaojuan;YANG Xinyue;CHEN Yan;WEN Ziqiang;YU Shenping(Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China;Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen 518036, China)

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]北京大学深圳医院医学影像科,广东深圳518036

出　　处：《中国医学影像技术》2018年第4期568-572,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(2014A020212126)

摘　　要：目的探讨直肠癌体素内不相干运动(IVIM)MRI参数测量的一致性和可重复性。方法对128例经病理证实的直肠腺癌患者于治疗前行直肠常规高分辨MR和IVIM扫描。选择两种b值组合(A组:0、5、10、20、30、40、60、80、100、150、200、400、600和1 000s/mm2;B组:0、5、10、20、30、40、60、80、100、150、200、400、600、1 000、1 500和2 000s/mm2),拟合计算出两组IVIM参数图,分别测量肿瘤区域单纯扩散系数(D)、假性扩散系数(D*)和灌注分数(f)值。由同一观察者间隔3个月重复测量肿瘤区域D、和f值;采用组内相关系数(ICC)和Bland-Altman图评价测量的一致性和可重复性。结果两种b值组合图像所测量D、、f值差异均有统计学意义(P均<0.001);D、及f值的ICC及95%置信区间分别为0.968(0.955,0.977)、0.780(0.688,0.845)和0.957(0.934,0.970);Bland-Altman图显示差异百分比的±1.96标准差分别为(10.8%,22.4%)、(14.8%,61.9%)、(-45.3%,-10.2%)。同一观察者2次测量值差异有统计学意义(P=0.001);D、及f值的ICC及95%置信区间分别为0.826(0.670,0.908)、0.678(0.392,0.830)和0.910(0.830,0.952);Bland-Altman图显示差异百分比的±1.96标准差分别为(-15.3%,12.4%)、(-39.6%,61.2%)、(-22.6%,22.9%)。结论两种b值组合图像测量直肠癌各IVIM参数的一致性良好,D值和f值测量的可重复性良好。Objective To explore the repeatability and consistency of MR intravoxel incoherent motion （IVIM） parameters of rectal cancers. Methods Routine high resolution rectal MR and IVIM sequence were performed on 128 patients with pathologically proved rectal cancers before treatment. IVIM maps were generated from two sets of b-values （group A.. 0, 5, 10, 20, 30, 40, 60, 80, 100, 150, 200, 400, 600 and 1 000 s/mm^2 ; group B： 0, 5, 10, 20, 30, 40, 60, 80, 100, 150, 200, 400, 600, 1 000, 1 500 and 2 000 s/mm2）, and IVIM parameters （D, D and f） were measured. Then IVIM parameters were measured again by the same observer three months later. The intra-class correlation coefficient （ICC） and Bland-Airman graph analysis were performed to explore the repeatability and consistency of IVIM parameters. Results The differences of IVIM parameters （D, D and f） derived from the two sets of b-values were statistically different （all P〈0. 001）. ICC and 950//oo confidence interval （CI） of D, D^＊ and f was 0. 968 （0. 955, 0. 977）, O. 780 （0. 688, 0. 845） and 0. 957 （0. 934, 0. 970）, respectively. Blancl-Altman analysis showed that the 95% limits of agreement of D, D^＊ and I was （10.8%, 22.4%）, （14.8%, 61.9%） and （-45.3%, -10.2%/）, respectively. There was significant difference of D＊ between twice measurement by the same observer （P=0. 001） ; ICC and 95%ff0CI of D, Dr and f was 0. 826 （0. 670, 0. 908）, 0. 678 （0. 392, 0. 830） and 0. 910 （0. 830, 0. 952）, respectively. Furthermore, Bland-Airman analysis showed that the 95% limits of agreement of D, Dr and f were （-15.3%0 , 12.4%） , （-39.6%, 61.2 %） and （-22.6% , 22.9%）, respectively. Conclusion Under the two different sets of b-values, all IVIM parameters of rectal cancers demonstrate good consistency. In addition, D and f value show good repeatability.

关 键 词：直肠肿瘤 磁共振成像 体素内不相干运动 一致性 可重复性 结果 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]