扩散加权成像多模型参数在软组织肉瘤组织病理分级中的价值  

Value of multi-model parameters derived from diffusion weighted imaging in histopathological grading of soft tissue sarcoma

作　　者：张凯 戴越 张丽娜[2] 赵晓宇 刘亚洁[1] 陶娟[3] 段志青 王绍武[1] ZHANG Kai;DAI Yue;ZHANG Lina;ZHAO Xiaoyu;LIU Yajie;TAO Juan;DUAN Zhiqing;WANG Shaowu(Department of Radiology,the Second Hospital of Dalian Medical University,Dalian,Liaoning Province 116023,China;Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province l16oll,China;Department of Pathology,the Second Hospital of Dalian Medical University,Dalian,Liaoning Province 116023,China)

机构地区：[1]大连医科大学附属第二医院放射科,辽宁大连116023 [2]大连医科大学附属第一医院放射科,辽宁大连116011 [3]大连医科大学附属第二医院病理科,辽宁大连116023

出　　处：《实用放射学杂志》2023年第1期99-103,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81771804)。

摘　　要：目的 探讨单指数、双指数及拉伸指数模型扩散加权成像(DWI)在软组织肉瘤(STS)组织病理分级中的应用价值.方法 前瞻性选取经病理证实的STS患者49例,共有51个病灶,其中低级别组20例,高级别组31例,在术前均行常规MRI及多b值DWI检查.使用Functool-MADC软件测得标准表观扩散系数(ADCstand)值、慢速表观扩散系数(ADCslow)值、快速表观扩散系数(ADCfast)值、灌注分数(f)值、分布扩散系数(DDC)值及扩散异质性指数(α)值.采用独立样本t检验或Mann-Whitney U检验对各参数进行组间比较.通过分析受试者工作特征(ROC)曲线,获得各参数鉴别高、低级别STS的诊断效能及最佳诊断阈值.结果 高级别组ADCstand、ADCslow、DDC及α值显著低于低级别组(P<0.05),各参数曲线下面积(AUC)分别为0.823、0.875、0.827和0.735.2组间ADCfast和f值的差异无统计学意义(P>0.05).2组中DDC值与ADCstand、ADCslow值均呈正相关(P<0.05).结论 单指数、双指数、拉伸指数模型DWI可用于术前预测STS的组织病理分级,ADCstand、ADCslow、DDC和α值具有较好的诊断效能.Objective To explore the application value of monoexponential,biexponential,and stretched-exponential diffusion weighted imaging(DWI)models in histopathological grading of soft tissue sarcoma(STS).Methods A total of 51 lessions from 49 patients with STS confirmed by pathology were prospectively selected,including 20 cases of low-grade group and 31 cases of high-grade group.All patients underwent routine MRI and multiple b-value DWI examinations before surgery.The standard apparent diffusion coefficient(ADC_(stand)),slow apparent diffusion coefficient(ADC_(slow)),fast apparent diffusion coefficient(ADC_(fast)),f,distributed diffusion coefficient(DDC)andαvalues were measured by Functool-MADC software.All parameters of the two groups were com-pared by independent sample t test or Mann-Whitney U test.The diagnostic efficacy and optimal diagnostic threshold to distinguish high-and low-grade STS were acquired from the receiver operating characteristic(ROC)curve.Results The ADC_(stand),ADC_(slow),DDC andαvalues in the high-grade group were significantly lower than those in the low-grade group(P<0.05).The area under the curve(AUC)of the above parameters were 0.823,0.875,0.827 and 0.735,respectively.The differences of ADC_(fast) and f values between the twogroups werenot statistically significant(P>0.05).In the two groups,DDC value was positively correlated with ADCsuand and ADC_(slow)values(P<0.05).Conclusion The monoexponential,biexponential,and stretched-exponential DWI models can predict the histopathological grading of STS before surgery.The ADC_(stand),ADCylow,DDC,andαvalues have good diagnostic efficiency.

关 键 词：软组织肉瘤 病理分级 扩散加权成像 体素内不相干运动 

分 类 号：R738.6[医药卫生—肿瘤] R446.8[医药卫生—临床医学] R445.2