动态对比增强MRI定量参数评估孤立实性结节肺癌病理分级及临床分期的价值  

The value of dynamic contrast-enhanced MRI quantitative parameters in the evaluation of pathological grading and clinical staging of solitary solid nodular lung cancer

作　　者：付靓 李凯[2] 李则锋 邓东[2] 张小波[2] 管学春[2] 李文美[2] 顾永耀[3] FU Liang;LI Kai;LI Zefeng;DENG Dong;ZHANG Xiaobo;GUAN Xuechun;LI Wenmei;GU Yongyao(Department of Radiolog y,the First Affiliated Hos pital of Guangxi University of Traditional Chinese Medicine,Nanning 530012,China;Department of Radiolog y,the First Affiliated Hos pital of Guangxi Medical University,Nanning 530021,China;Department of Patholog y,the First Affiliated Hos pital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西中医药大学第一附属医院放射科,广西南宁530012 [2]广西医科大学第一附属医院放射科,广西南宁530021 [3]广西医科大学第一附属医院病理科,广西南宁530021

出　　处：《实用放射学杂志》2021年第11期1785-1789,共5页Journal of Practical Radiology

基　　金：广西自然科学基金资助项目(2016GXNSFAA380137)。

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)定量参数评估在孤立实性结节肺癌患者病理分级及临床分期中相关应用价值。方法32例患者均经手术病理证实为孤立实性结节肺癌,术前行MR常规序列平扫及DCE-MRI扫描,所得原始数据导入后处理软件Tissu4D进行人工测量病灶,获取容积转运常数(Ktrans)、速率常数(Kep)和血管外细胞外间隙容积分数(Ve)值最终数据;术后标本采用HE染色和免疫组化进行标记。结果低级别组孤立实性结节肺癌Ktrans值高于高级别组(P<0.05),呈正相关(r=0.339);绘制受试者工作特征(ROC)曲线亦得出该值的敏感性及特异性均较高。另外,孤立实性结节肺癌不同临床分期间各定量参数均有统计学意义(P<0.05),且呈正相关(r分别为0.14、0.17及0.15);将上述数据纳入Logistic回归分析,Ve值最有意义。结论DCE-MRI定量参数中Ktrans值与Ve值分别用于评估孤立实性结节肺癌病理分级及临床分期具有较好的效能和潜力,值得临床进一步推广使用。Objective To investigate the application value of some quantitative parameters by dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the evaluation of pathological grading and clinical staging in patients with solitary solid nodular lung cancer.Methods 32 patients who received surgery and were confirmed as solitary solid nodular lung cancer by pathology were collected in the study.Conventional plain MR sequences and DCE-MRI scan were conducted before operation.The original data were imported into the post-processing software Tissu4D to measure the size of lesions artificially and obtain the final values of Ktrans,Kep and Ve.Postoperative specimens were analyzed with HE staining and immunohistochemistry.Results The Ktrans value of solitary solid nodular lung cancer in the low-grade group was significantly higher than that in the high-grade group(P<0.05),and presented as a positive correlation(r=0.339).The sensitivity and specificity of the value were also higher according to the drawn receiver operating characteristic(ROC)curves.Besides,the differences in the quantitative parameters of solitary solid nodular lung cancer among different clinical stages were statistically significant(P<0.05),and the positive correlations were shown(r=0.14,0.17 and 0.15,respectively).The Logistic regression analysis showed that the Ve value was the most significant.Conclusion The Ktrans and Ve values of DCE-MRI has good efficacy and potential for evaluating the pathological grading and clinical staging of solitary solid nodular lung cancer respectively,which is worthy of further clinical application.

关 键 词：动态对比增强磁共振成像 肺结节 定量参数 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]