DCE-MRI定量参数预测胰腺癌组织生物学特征的初步研究  

A preliminary study on DCE-MRI quantitative parameters in predicting the histobiological features of pancreatic cancer before operation

作　　者：赵娓娓 宦怡 郑敏文 任静 韩志巍 ZHAO Wei-wei;HUAN Yi;ZHEN Min-wen(Department of Radiology,the Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院放射科,西安710032

出　　处：《放射学实践》2021年第4期502-506,共5页Radiologic Practice

基　　金：国家自然科学基金(81220108011);西京医院学科助推资助项目(XJZT19ML03)。

摘　　要：目的:探讨DCE-MRI药代动力学参数术前无创性评估胰腺癌组织生物学状况的可行性。方法:21例经病理证实的胰腺癌患者术前均行胰腺DCE-MRI扫描,测量病灶的药代动力学参数K_(trans)、K_(ep)、V_(e)和V_(p)。采用独立样本t检验比较不同临床及病理状况时各项定量参数的差异。采用ROC曲线评估各项定量参数对胰腺癌不同组织生物学状况的诊断效能。结果:胰头区肿瘤的V_(p)高于体尾部(P=0.014);最大径>3 cm和Ⅱ~Ⅲ期胰腺癌的K_(trans)、K_(ep)分别高于最大径≤3 cm(P=0.036、0.026)及Ⅰ期胰腺癌(P=0.005、0.037);低分化胰腺癌的K_(trans)、K_(ep)和V_(p)均高于中~高分化胰腺癌(P=0.007、0.003和0.036),而V_(e)低于中~高分化胰腺癌(P<0.001);伴血管侵犯胰腺癌的K_(trans)、K_(ep)和V_(p)均高于不伴血管侵犯者(P=0.007、0.015和0.003);伴淋巴转移胰腺癌的K_(trans)、K_(ep)和V_(e)均高于不伴淋巴转移者(P=0.012、0.028和0.049)。K_(trans)和K_(ep)鉴别Ⅱ~Ⅲ期与Ⅰ期胰腺癌的AUC分别为0.931和0.812;K_(trans)、K_(ep)、V_(e)和V_(p)鉴别低分化与中~高分化胰腺癌的AUC分别为0.829、0.843、0.926和0.750;K_(trans)、K_(ep)和V_(p)评估胰腺癌有无血管侵犯的AUC分别为0.817、0.832和0.875;K_(trans)、K_(ep)和V_(e)评估胰腺癌有无淋巴转移的AUC分别为0.796、0.801和0.755。结论:胰腺癌DCE-MRI药代动力学参数能在术前无创性评估胰腺癌的组织生物学状况,有助于精准诊断及治疗。Objective:To explore the feasibility of preoperative noninvasive predicting the histobiological properties of pancreatic cancer using DCE-MRI pharmacokinetic parameters.Methods:21 patients with pathologically confirmed pancreatic cancer were enrolled in this study.All patients underwent dynamic contrast-enhanced(DCE)-MRI before operation,and the pharmacokinetic parameters(K_(trans),K_(ep),V_(e) and V_(p))of each lesion were measured.Independent sample t-test was used to compare the differences of the four quantitative parameters of pancreatic cancer between different groups.ROC curve was used to evaluate the diagnostic efficacy of the quantitative parameters for prediction the different biological properties of pancreatic cancer.Results:The V_(p) of the lesions in the pancreatic head was higher than that in the body and tail(P=0.014).The K_(trans)and K_(ep)of pancreatic cancer with maximum diameter>3cm or stageⅡ~Ⅲwere higher than those of the maximum diameter≤3cm(P=0.036 and 0.026)or stageⅠ(P=0.005 and 0.037),respectively.The K_(trans),K_(ep)and V_(p) of poorly differentiated pancreatic cancer were all higher than those of moderately to highly differentiated pancrea-tic cancer(P=0.007,0.003 and 0.036),while the V_(e) was lower(P<0.001).The K_(trans),K_(ep)and V_(p) of pancreatic cancer with vascular invasion were all higher than those without vascular invasion(P=0.007,0.015 and 0.003).The K_(trans),K_(ep)and V_(e) of pancreatic cancer with lymphatic metastasis were all higher than those without lymphatic metastasis(P=0.012,0.028 and 0.049).The AUC of K_(trans)and K_(ep)for differentiating stageⅡ~Ⅲfrom stageⅠpancreatic cancer were 0.931 and 0.812,respectively;the AUC of K_(trans),K_(ep),V_(e) and V_(p) for distinguishing poorly differentiated from moderately to highly differentiated pancreatic cancer were 0.829,0.843,0.856 and 0.750,respectively;the AUC of K_(trans),K_(ep)and V_(p) in evaluating with or without vascular invasion were 0.817,0.832 and 0.875,respectively;the AUC of K_(trans),K_(ep)and V

关 键 词：胰腺癌 磁共振成像 动态对比增强 药代动力学参数 组织生物学 

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]