胰岛细胞瘤体素内不相干运动参数与CT灌注参数的相关性  

Correlation of Intravoxel Incoherent Motion-derived Parameters with Computer Tomography Perfusion Parameters in Insulinoma

作　　者：何铭 徐进[1] 孙照勇[1] 王士阗 李娟[1] 王小奇 王家正 朱亮[1] 薛华丹[1] 金征宇[1] HE Ming;XU Jin;SUN Zhaoyong;WANG Shitian;LI Juan;WANG Xiaoqi;WANG Jiazheng;ZHU Liang;XUE Huadan;JIN Zhengyu(Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Imaging Systems Clinical Science Philips Healthcare,Beijing 100600,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]飞利浦影像研究院,北京100600

出　　处：《中国医学科学院学报》2020年第2期139-146,共8页Acta Academiae Medicinae Sinicae

基　　金：中国医学科学院医学与健康科技创新工程(2017-12M-1-001);北京协和医院杰出青年基金(JQ201704)。

摘　　要：目的评估胰岛素瘤体素内不相干运动(IVIM)相关参数和CT灌注参数及病理学分级的相关性。方法前瞻性收集北京协和医院怀疑胰岛素瘤且行IVIM和CT灌注扫描的患者共55例,对图像进行后处理得到IVIM相关参数[包括表观扩散系数(ADC)、真实扩散系数(D)、灌注相关扩散系数(D*)和灌注分数(f)]和CT灌注参数[包括血流量(BF)、血容量(BV)和渗透性(PM)]。对术后病理标本进行染色获得病理学指标(包括分级、ki-67指数和核分裂相)。比较正常胰腺不同解剖部位及正常胰腺与胰岛素瘤的IVIM相关参数差异。分析IVIM参数与CT灌注参数及病理学指标的相关性。结果胰尾ADC值及D值均明显减低,差异有统计学意义(P均<0.001)。胰岛素瘤及正常胰腺的所有IVIM参数差异均有统计学意义(P均<0.001)。正常胰腺的ADC值、f值与BF呈正相关(r=0.437,P=0.003;r=0.357,P=0.010),余IVIM相关参数与CT灌注参数均无相关性(P均>0.05)。IVIM参数与胰岛素瘤病理学分级指标间均无相关性(P均>0.05)。结论正常胰腺的不同解剖部位的IVIM参数有差异,IVIM参数可区分正常胰腺实质及胰岛素瘤。ADC值与CT灌注参数BF具有相关性,但相关性较弱。Objective To prospectively evaluate the correlation between intravoxel incoherent motion(IVIM)-derived parameters and CT perfusion parameters as well as the pathological grade in insulinoma.Methods A total of 55 patients with suspected insulinoma undergoing IVIM and CT perfusion scans were prospectively enrolled.The images were post-processed to obtain IVIM parameters including apparent diffusion coefficient(ADC),diffusion(D),perfusion correlated diffusion(D*),and f,and CT perfusion parameters including blood flow(BF),blood volume(BV),and permeability(PM).The pathological specimens were stained to obtain pathological parameters including the grading,ki-67 index,and the mitotic count.The IVIM derived parameters of normal pancreas including head,body,and tail as well as that of the pancreatic insulinoma were compared.The correlation between IVIM parameters and CT perfusion parameters as well as the pathological parameters was analyzed.Results ADC and D values of pancreatic tail were significantly lower than those of the pancreatic head and neck(all P<0.001).There were significant differences in all IVIM parameters between insulinoma and normal pancreas(all P<0.001).The ADC and f value of the normal pancreas was positively correlated with BF(r=0.437,P=0.003;r=0.357,P=0.010).There is no correlation between the remaining IVIM parameters and the CT perfusion parameters as well as between IVIM parameters and pathological parameters(all P>0.05).Conclusions IVIM parameters differ at different anatomical parts of normal pancreas.IVIM parameters can distinguish normal pancreatic parenchyma from insulinoma.The ADC value is weakly correlated with BF.

关 键 词：弥散加权成像 计算机断层扫描 灌注 胰岛素瘤 分级 

分 类 号：R445.2[医药卫生—影像医学与核医学]