非对称回波的最小二乘估算法迭代水脂分离序列和弥散加权成像评估肝细胞癌Ki-67表达  

MR iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron sequence and diffusion weighted image for evaluating expression of Ki-67 of hepatocellular carcinoma

作　　者：王学东 陈敏 刘秀娟 于向荣 王玲杰 WANG Xuedong;CHEN Min;LIU Xiujuan;YU Xiangrong;WANG Lingjie(Department of Radiology,Zhuhai People's Hospital,Zhuhai 519000,China;Department of Pathology,Zhuhai People's Hospital,Zhuhai 519000,China)

机构地区：[1]珠海市人民医院(暨南大学附属珠海医院)放射科,广东珠海519000 [2]珠海市人民医院(暨南大学附属珠海医院)病理科,广东珠海519000

出　　处：《中国医学影像技术》2022年第1期98-102,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察非对称回波的最小二乘估算法迭代水脂分离序列(IDEAL-IQ)和弥散加权成像(DWI)评估肝细胞癌(HCC)Ki-67表达情况的价值。方法回顾性收集40例病理确诊为原发性HCC的患者,按照Ki-67表达指数将患者分为高表达(Ki-67表达指数>10%)组(n=23)和低表达(Ki-67表达指数≤10%)组(n=17),测量并比较2组病灶R2^(*)值、脂肪分数(FF)及表观弥散系数(ADC)。绘制受试者工作特征(ROC)曲线,观察R2^(*)值、FF及ADC评估HCC的Ki-67表达情况的效能。结果高表达组HCC的R2^(*)值高于低表达组(P<0.001),ADC低于低表达组(P=0.006),而组间FF差异无统计学意义(P=0.125)。以25.88 s^(-1)为R2^(*)值的截断值,其鉴别HCC Ki-67高、低表达的敏感度、特异度及AUC分别为60.90%、94.10%及0.867;以0.83×10^(-3) mm^(2)/s为ADC的截断值,其敏感度、特异度及AUC分别为94.10%、39.10%及0.703;以0.33为R2^(*)值联合ADC的截断值,其敏感度、特异度及AUC分别为94.10%、69.60%及0.870,且其AUC高于单一ADC的AUC(Z=1.988,P=0.047)。HCC患者Ki-67表达与病灶R2^(*)值呈高度正相关(r=0.84,P<0.001),与ADC呈中度负相关(r=-0.62,P<0.001)。结论MR IDEAL-IQ和DWI可有效评估HCC Ki-67表达;R2^(*)值联合ADC诊断价值最高。Objective To observe the value of MR iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron sequence(IDEAL-IQ)and diffusion weighted image(DWI)for evaluating the expression of Ki-67 of hepatocellular carcinoma(HCC).Methods Totally 40 patients with primary HCC proved with pathology were retrospectively collected and divided into high expression(expression index>10%)group(n=23)and low expression(expression index≤10%)group(n=17)according to Ki-67 expression.The R2^(*)value,fat fraction(FF)and apparent diffusion coefficient(ADC)of HCC were measured and compared between groups.The receiver operating characteristic(ROC)curve was drawn to observe the efficacy of R2^(*)value,FF and ADC for evaluating the expression of Ki-67 of HCC.Results R2^(*)value in high expression group was higher than that in low expression group(P<0.001),and ADC was lower than that in low expression group(P=0.006),while there was no significant difference of FF between groups(P=0.125).Taken 25.88 s^(-1) as the cutoff value of R2^(*)value for distinguishing high or low expression of Ki-67 of HCC,the sensitivity,specificity and AUC was 60.90%,94.10%and 0.867,respectively.Taken 0.83×10^(-3) mm^(2)/s as the cutoff value of FF,the sensitivity,specificity and AUC was 94.10%,39.10%and 0.703,respectively.Taken 0.33 as the cutoff value of R2^(*)combined with ADC,the sensitivity,specificity and AUC was 94.10%,69.60%and 0.870,respectively,and the AUC was higher than that of single ADC(Z=1.988,P=0.047).The expression of Ki-67 of HCC strongly positively correlated with R2^(*)value(r=0.84,P<0.001),but strongly negatively correlated with ADC(r=-0.62,P<0.001).Conclusion MR IDEAL-IQ and DWI could effectively evaluate the expression of Ki-67 of HCC,and R2^(*)value combined with ADC had the highest diagnostic value.

关 键 词：癌 肝细胞 KI-67 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]