扩散张量成像定量参数预测子宫内膜癌微卫星不稳定状态  

Quantitative parameters of diffusion tensor imaging predicting microsatellite instability in endometrial carcinoma

作　　者：田士峰[1] 刘爱连[1] 杨伟萍 武敬君 陈安良[1] 魏强[1] TIAN Shifeng;LIU Ailian;YANG Weiping;WU Jingjun;CHEN Anliang;WEI Qiang(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011

出　　处：《实用放射学杂志》2021年第5期804-808,834,共6页Journal of Practical Radiology

基　　金：首都科技领军人才培养工程项目(Z181100006318003).

摘　　要：目的探讨扩散张量成像(DTI)定量参数预测子宫内膜癌(EC)微卫星不稳定(MSI)状态的价值.方法回顾性分析37例经手术病理证实为EC的患者资料,其中MSI12例,微卫星稳定(MSS)25例,术前MR检查包括扩散加权成像(DWI)、DTI序列.测量2组病例实质区DWI的表观扩散系数(ADC)值,DTI的平均扩散系数(DCavg)、各向异性分数(FA)、各向同性(Iso)、容积比各向异性分数(VRA)、衰减指数(Exat)以及T2加权迹线(T2GWT)值,检验测量结果的一致性,分析2组病例各自ADC和DCavg值的相关性,比较2组病例间各参数值的差异,评估并比较有差异参数预测MSI的效能.结果各组数据测量结果一致性很好,组内相关系数(ICC)>0.75.MSI组的ADC、DCavg值小于MSS组,FA、VRA、Exat值大于MSS组,差异均有统计学意义(P<0.05),2组间Iso、T2GWT值差异无统计学意义(P>0.05).MSI组和MSS组各自组内ADC、DCavg值有高度相关性(r=0.906、0.868,P<0.001).ADC、DCavg、FA、VRA以及Exat值预测EC MSI的曲线下面积(AUC)分别为0.698、0.720、0.783、0.743、0.725,各AUC之间均无统计学差异(P>0.05).结论DTI可提供多个预测ECMSI的定量参数,DCavg值与DWI序列的ADC值高度相关.Objective To explore the value of quantitative parameters of diffusion tensor imaging(DTI)in predicting microsatellite instability(MSI)of endometrial carcinoma(EC).Methods The data of 37 patients with EC confirmed by surgical pathology were analyzed retrospectively,which including 12 cases of MSI and 25 cases of microsatcllite stability(MSS).The preoperative MR scanning sequences included diffusion weighted imaging(DWI)and DTI.The apparent diffusion coefficient(ADC)values of DWI,the average diffusion coefficient(DCavg),the fractional anisotropy(FA),the isotropy(Iso),the volume ratio anisotropy(VRA),the exponential attenuation(Exat)and the T2-wcighted trace(T2-WT)values of DTI were measured.The consistency of the results was tested,the correlations between ADC and DCavg values of the two groups were analyzed,the differences of the parameter values between the two groups were compared,and the efficacies of the different parameters predicting MSI were evaluated and compared.Results The data consistency of each group was good[intraclass correlation coefficients(ICC)>0.75].The ADC,DCavg values of the MSI group were significantly lower than those of the MSS group,the FA,VRA,Exat values of the MSI group were significantly higher than those of the MSS group(P<0.05).There were no statistical differences in Iso and T2-WT values between the two groups(P>0.05).The values of ADC and DCavg in the MSI group and the MSS group were highly correlated(r=0.906,0.868,P<0.001).The area under the curve(AUC)of EC MSI predicted by ADC,DCavg,FA,VRA and Exat values were 0.698,0.720,0.783,0.743 and 0.725,respectively.There were no statistical differences among each AUC(P>0.05).ConcIusion DTI can provide several quantitative parameters for predicting EC MSI,among which DCavg value is highly correlated with ADC value of DWI.

关 键 词：子宫内膜癌 微卫星不稳定 磁共振成像 扩散张量成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]