增强T_(1)mapping和ZOOMit IVIM成像的定量参数与肺癌Ki67表达的相关性及预测价值  

Correlation and predictive value of quantitative parameters of enhanced T_(1)mapping and ZOOMit intravoxel incoherent motion imaging with Ki67 expression in lung cancer

作　　者：郭文秀 赵鹏 林祥涛[1,2] 苑乐添 杨涛[2] 田迷迷 Guo Wenxiu;Zhao Peng;Lin Xiangtao;Yuan Letian;Yang Tao;Tian Mimi(Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院医学影像科,济南250021 [2]山东大学附属省立医院医学影像科,济南250021

出　　处：《中华解剖与临床杂志》2023年第6期357-364,共8页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨增强T_(1)mapping和缩放成像技术的体素内不相干运动(ZOOMit IVIM)成像的定量参数与肺癌Ki67表达的相关性,以及对肺癌Ki67表达预测价值的比较。方法回顾性纳入2020年9月—2022年4月山东第一医科大学附属省立医院52例经病理证实的肺癌患者的临床和MRI资料。患者男37例、女15例,年龄50~79岁(中位年龄63岁),术前均行增强T_(1)mapping和ZOOMit IVIM成像。测量病变的定量参数:ZOOMit IVIM定量参数包括表观弥散系数(ADC)、真弥散系数(D)、灌注分数(f)、伪弥散系数(D*);增强T_(1)mapping定量参数包括增强前、后T_(1)值(T_(1)pre、T_(1)post),T_(1)增强前后的变化值(ΔT_(1))及T_(1)值的变化百分比(ΔT_(1)%)。根据患者病理检查细胞染色结果计算阳性细胞所占细胞总数的百分比(Ki67表达指数),以25%为界将患者分为低表达组(Ki67表达指数≤25%)和高表达组(Ki67表达指数>25%)。观察指标:(1)比较2组患者的性别、年龄、病灶大小等基线资料。(2)分析各定量参数与肺癌Ki67表达指数间的相关性。(3)比较各定量参数在2组不同肺癌Ki67表达状态时的差异。(4)评价和比较差异有统计学意义的定量参数对Ki67高表达组的鉴别诊断效能。(5)分析2种成像中与灌注相关的参数之间的相关性。结果52例患者中,Ki67低表达组19例,Ki67高表达组33例。(1)2组患者的性别、年龄、病灶大小差异均无统计学意义(P值均>0.05)。(2)ADC、D、ΔT_(1)、ΔT_(1)%与肺癌Ki67表达指数呈负相关,T_(1)post与Ki67表达指数呈正相关,其中以ΔT_(1)%相关性最强(r=-0.659,P<0.001);D*、f、T_(1)pre与Ki67表达指数无明显相关。(3)肺癌Ki67高表达组的ADC、D、ΔT_(1)、ΔT_(1)%均低于低表达组,T_(1)post高于低表达组,差异均有统计学意义(P值均<0.01);D*、f、T_(1)pre在2组之间的差异均无统计学意义(P值均>0.05)。(4)2种成像中诊断效能最高的定量参数分别为ADC与ΔT_(1)%(AUC=0.799、0.941)Objective This study aims to investigate the correlation between the quantitative parameters of intravoxel incoherent motion imaging based on ZOOM imaging technology(ZOOMit IVIM)and enhanced T_(1)mapping and the expression index of Ki67 in lung cancer and to compare the predictive value of these parameters for Ki67 expression in lung cancer.Methods In this retrospective study,the clinical and MRI data of 52 patients with pathologically confirmed lung cancer in Shandong Provincial Hospital Affiliated with Shandong First Medical University from September 2020 to April 2022 were included.The participants included 37 males and 15 females,aged 50-79 years(median age 63 years),and all of them underwent enhanced T_(1)mapping and ZOOMit IVIM imaging before surgery.The following quantitative parameters were measured for lesions based on ZOOMit IVIM imaging:apparent diffusion coefficient(ADC)value,true diffusion coefficient(D)value,pseudo-diffusion coefficient(D*)value,and perfusion fraction(f)value.The quantitative parameters of the enhanced T_(1)mapping included T_(1)value before and after injection of the contrast medium(T_(1)pre,T_(1)post)and the change value of T_(1)(ΔT_(1))as well as the percentage of change(ΔT_(1)%).According to the results of pathological examination and cell staining,the percentage of positive cells in the total number of cells(Ki67 index)was calculated.The patients were divided into 19 cases in the low expression group(Ki67 index≤25%)and 33 cases in the high expression group(Ki67 index>25%)with a cut-off of 25%.Observation index was used:(1)compare the baseline data of gender,age,and lesion size of two groups;(2)to analyze the correlation between each parameter and the expression index of Ki67 in lung cancer;(3)to explore the difference between the quantitative parameters in the different expression groups of Ki67;(4)to evaluate and compare the differential diagnostic efficacy of quantitive parameters with statical significance significance on Ki67 expression;(5)to investigate the correlation

关 键 词：肺肿瘤 功能磁共振成像 KI67抗原 T_(1)mapping技术 体素内不相干运动 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]