动态对比增强MRI参数联合纹理分析对宫颈癌细胞增殖活性的评估价值  

The value of dynamic contrast-enhanced MRI parameters and texture analysis for predicting the proliferation activity in cervical cancer patients

作　　者：颜梅 温生宝[1] 王雪燕[1] 韩国财 尹启超[1] YAN Mei;WEN Shengbao;WANG Xueyan;HAN Guocai;YIN Qichao(Imaging Center,the Affiliated Hospital of Qinghai University,Xining 810000,China)

机构地区：[1]青海大学附属医院影像中心,青海西宁810000

出　　处：《实用放射学杂志》2023年第3期428-432,共5页Journal of Practical Radiology

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)参数联合纹理分析对宫颈癌细胞增殖活性的评估价值。方法回顾性选取64例宫颈癌患者,获取宫颈癌细胞增殖活性指标,包括增殖细胞核抗原(PCNA)及增殖细胞相关抗原Ki-67。所有患者均在手术或内镜前1周内行DCE-MRI扫描,记录DCE-MRI参数:最大斜率(Max_(slope))、对比增强率(CER)、对比剂浓度-时间曲线下面积(iAUC)、转运常数(K^(trans))、速率常数(K_(ep))、血管外细胞间隙体积百分数(V_(e))值。将DCE-MRI原始图像导入Omni Kinetics软件进行纹理分析。比较DCE-MRI参数及纹理参数在不同细胞增殖活性组织间的差异,采用受试者工作特征(ROC)曲线分析参数的诊断效能。结果PCNA及Ki-67低表达组的K^(trans)、平均值、Short Run High Grey Level Emphasis显著低于高表达组,能量值显著高于高表达组。Ki-67低表达组的CER显著低于高表达组,均匀性显著高于高表达组。K^(trans)诊断PCNA及Ki-67的曲线下面积(AUC)分别为0.748、0.714,CER诊断Ki-67的AUC为0.703。单个纹理参数对PCNA及Ki-67的诊断效能在0.621~0.706之间,将DCE-MRI参数与纹理参数联合后,对PCNA及Ki-67的诊断效能分别为0.858(敏感度0.880、特异度0.718)、0.910(敏感度0.828、特异度0.857)。结论DCE-MRI参数联合纹理分析可用于评估PCNA及Ki-67的表达水平,有望作为评估宫颈癌细胞增殖活性的影像学手段,从而辅助临床决策。Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters and texture analysis for predicting the proliferation activity in cervical cancer patients.Methods Sixty-four cervical cancer patients were retrospectively selected,and the proliferation activity marker including proliferating cell nuclear antigen(PCNA)and proliferating cell associated antigen Ki-67 were obtained.All patients underwent DCE-MRI within a week before surgery or endoscope.The DCE-MRI parameters[Max_(slope),contrast enhancement ratio(CER),contrast agent iAUC,K^(trans),K_(ep),V_(e)]were recorded.The original images of DCE-MRI were imported into Omni Kinetics software to perform texture analysis.The differences of DCE-MRI and texture parameters between different cell proliferation activity tissues were compared,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency.Results The K^(trans),average,and Short Run High Grey Level Emphasis of the PCNA and Ki-67 low expression group were significantly lower than high expression group,and the energy value was significantly higher than high expression group.The CER of the Ki-67 low expression group was significantly lower than high expression group,and the uniformity was significantly higher than high expression group.The diagnosed value of K^(trans) for PCNA and Ki-67 with area under the curve(AUC)were 0.748 and 0.714,respectively,and CER was 0.703 for Ki-67.The diagnostic efficiency of single texture parameter for PCNA and Ki-67 were between 0.621 and 0.706.After combined DCE-MRI and texture parameters,the diagnostic efficiency of PCNA and Ki-67 were 0.858(sensitivity 0.880,specificity 0.718)and 0.910(sensitivity 0.828,specificity 0.857),respectively.Conclusion DCE-MRI parameters and texture analysis can be used to assess the expression level of PCNA and Ki-67,which may help to predict the proliferation activity and assist clinical decision-making in cervical cancer patients.

关 键 词：动态对比增强磁共振成像 宫颈癌 增殖细胞核抗原 KI-67 

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] R446.8[医药卫生—临床医学]