弥散峰度成像定量参数对直肠癌淋巴结转移的诊断价值  

Diagnostic value of diffusion kurtosis imaging quantitative parameters in lymph node metastasis of rectal cancer

作　　者：郭晋锋 李丹丹 杜笑松[2] 杨晓棠[2] Guo Jinfeng;Li Dandan;Du Xiaosong;Yang Xiaotang(Hospital Office,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Medical Imaging,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院医院办公室,太原030013 [2]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院医学影像科,太原030013

出　　处：《肿瘤研究与临床》2023年第4期263-266,共4页Cancer Research and Clinic

摘　　要：目的:探讨弥散峰度成像(DKI)定量参数对直肠癌淋巴结转移的诊断价值。方法:回顾性分析山西省肿瘤医院2016年11月至2017年3月79例直肠腺癌患者的临床病理资料。患者术前均行常规磁共振成像(MRI)序列和DKI序列检查,由2名放射科医师勾画感兴趣区,应用Matlab软件计算两组DKI定量参数表观扩散系数(ADC)、平均弥散系数(MD)、平均峰度系数(MK),采用组内相关系数(ICC)进行一致性分析。依据术后病理结果,将患者分为淋巴结转移组和无淋巴结转移组,比较两组ADC、MD及MK。以病理诊断结果为金标准,绘制DKI定量参数诊断直肠癌淋巴结转移的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),依据约登指数确定最佳诊断阈值,计算灵敏度和特异度。结果:2名医师计算ADC、MD及MK的ICC分别为0.934(0.833~0.975)、0.963(0.905~0.981)、0.971(0.949~0.991),2人测量结果一致性良好。79例直肠腺癌患者中,淋巴结转移组36例,无淋巴结转移组43例。淋巴结转移组MK大于无淋巴结转移组,差异有统计学意义(0.97±0.08比0.89±0.09;t=-4.07, P<0.001),ADC、MD均小于无淋巴结转移组,但两组差异均无统计学意义(均 P>0.05)。MK诊断直肠癌淋巴结转移的AUC为0.735,灵敏度和特异度分别为55.56%和88.37%。 结论:DKI定量参数MK对直肠癌淋巴结转移有一定的诊断价值。Objective To investigate the diagnostic value of diffusion kurtosis imaging(DKI)quantitative parameters in lymph node metastasis of rectal cancer.Methods The clinicopathological data of 79 patients with rectal cancers in Shanxi Province Cancer Hospital from November 2016 to March 2017 were retrospectively analyzed.All patients underwent routine magnetic resonance image(MRI)sequence and DKI sequence examinations before the operation.The tumor region of interest(ROI)was delineated by two radiologists.Matlab software was applied to calculate DKI quantitative parameters including apparent diffusion coefficient(ADC),mean diffusivity(MD)and mean kurtosis(MK)in two groups,respectively;and the consistency analysis was performed by using the interclass correlation coefficients(ICC).According to the results of postoperative pathology,all patients were divided into lymph node metastasis group and lymph node non-metastasis group;ADC,MD,MK of both groups were compared.The pathological diagnosis results were taken as the gold standard,receiver operating characteristic(ROC)curves of DKI quantitative parameters in the diagnosis of lymph node metastasis of rectal cancer were plotted,the area under the curve(AUC)was calculated,the optimal diagnostic threshold was determined based on the Yoden index,and the sensitivity and specificity were calculated.Results The ICC of ADC,MD and MK calculated by two physicians were 0.934(0.833-0.975),0.963(0.905-0.981)and 0.971(0.949-0.991),respectively,showing a good inter-observer consistency.Among the 79 patients with rectal adenocarcinoma,36 cases were in lymph node metastasis group and 43 cases were in lymph node non-metastasis group.MK value in lymph node metastasis group was higher than that in lymph node non-metastasis group,and the difference was statistically significant(0.97±0.08 vs.0.89±0.09;t=-4.07,P<0.001),while the ADC and MD values in lymph node metastasis group were lower than those in lymph node non-metastasis group,and the differences were not statistically significant(all P>0

关 键 词：直肠肿瘤 淋巴结转移 弥散峰度成像 表观扩散系数 诊断 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]