体素内不相干运动及扩散峰度成像在宫颈鳞癌临床分期及病理分级中的评估价值  

The value of intravoxel incoherent motion and diffusion kurtosis imaging in clinical stage and pathological grade of cervical squamous cell carcinoma

作　　者：郝光宇[1,2] 陈蒙[1,2] 汪纯洁[3] 胡粟 朱默 王希明[1,2] 胡春洪[1,2] HAO Guangyu;CHEN Meng;WANG Chunjie;HU Su;ZHU Mo;WANG Ximing;HU Chunhong(Department of Radiology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China;Institute of Medical Imaging,Soochow University,Suzhou,Jiangsu Province 215006,China;Department of Radiology,Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006 [2]苏州大学医学影像研究所,江苏苏州215006 [3]浙江大学医学院附属杭州市第一人民医院放射科,浙江杭州310006

出　　处：《实用放射学杂志》2022年第1期99-103,共5页Journal of Practical Radiology

摘　　要：目的 探讨体素内不相干运动(IVIM)和扩散峰度成像(DKI)对宫颈鳞癌(CSCC)的诊断价值.方法 纳入经病理证实且未经任何治疗的CSCC患者42例,所有患者均于术前接受IVIM和DKI检查,并获得定量参数:纯扩散系数(D)、假扩散系数(D?)、灌注分数(f)、平均扩散峰度(MK)、平均扩散系数(MD).采用独立样本t检验比较在不同临床分期、病理分级和淋巴结转移情况下IVIM和DKI各项参数是否存在统计学差异,并应用曲线下面积(AUC)评估各项参数的诊断效能.结果 早期CSCC患者的MK值较晚期显著降低(P<0.01),MD值升高(P<0.05),D、D?、f值均无统计学意义.低分化和中/高分化组比较,D、f、MK和MD值均有统计学差异(P<0.01),AUC值分别为0.830、0.712、0.849、0.805,而D?在2组中无统计学差异.淋巴结转移者较未转移者D值(P<0.01)、MD值(P<0.05)显著减低,MK(P<0.01)明显升高,AUC值分别为0.851、0.898和0.808,而D?、f在2组中均无显著差异.结论 IVIM和DKI的各项参数中,MK和MD有助于术前评估CSCC的临床分期、肿瘤分化程度及淋巴结转移情况,D值有助于判断肿瘤的分化程度和转移情况,f值在评估分化程度中具有一定价值.Objective To explore and compare the capabilities of intravoxel incoherent motion(IVIM)and diffusion kurtosis imaging(DKI)in assessing cervical squamous cell carcinoma(CSCC).Methods 42 patients,without any treatments,who were pathologically confirmed CSCC were enrolled.IVIM and DKI were performed to obtain quantitative parameters.D,D*,f,mean kurtosis(MK)value and mean diffusion(MD)value were calculated and compared with regard to different clinical stages,pathological grades and lymph node metastases of tumor.Diagnostic performances of statistically significant parameters were evaluated by the area under the curve(AUC).Results MK value of early stage was significantly lower than advanced stage(P<0.01),with MD value of early stage higher than advanced stage(P<0.05).while D,D*,f values had no statistical significance.D,f,MK and MD values were significantly different between poor and moderate/well differentiations(all P<0.01),while there was no significant difference exhibited in D*value.The AUC of D,f,MK and MD values were 0.830,0.712,0.849 and 0.805,respectively.Patients with lymph node metastases,compared with those without,had significantly decreased D,MD values(P<0.01 and P<0.05,respectively)and increased MK value(P<0.01),but D*and f values did not reach statistical significance.The AUC of D,MD and MK values were 0.851,0.898 and 0.808 respectively.Conclusion Among the parameters of IVIM and DKI,MK and MD values are helpful for preoperative evaluation of clinical stages,pathological grades and lymph node metastases of CSCC,D value is beneficial to determine the pathological grades and metastasis of tumor,and f value has some value in the evaluation of pathological grades.

关 键 词：体素内不相干运动 扩散峰度成像 宫颈鳞癌 临床分期 病理分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]