PET/MRI扩散成像与代谢成像参数在评价肺腺癌Ki-67指数中的价值  

The value of parameters of PET/MRI diffusion imaging and metabolic imaging in evaluating Ki-67 index in lung adenocarcinoma

作　　者：姜涵 李自强 付芳芳[2] 杨洋 袁建闵 王梅云 JIANG Han;LI Ziqiang;FU Fangfang;YANG Yang;YUAN Jianmin;WANG Meiyun(Xinciang Medical University,He'nan Provincial People's Hospital,Zhengzhou 450003,China;Department of Imaging,He'nan Provincial People's Hospital,Zhengzhou 450003,China;Beijing United Imaging Research Institute of Intelligent Imaging,Beijing 100089,China;Central Research Institute,United Imaging Healthcare,Shanghai 201807,China)

机构地区：[1]新乡医学院·河南省人民医院,河南郑州450003 [2]河南省人民医院影像科,河南郑州450003 [3]北京联影智能影像技术研究院,北京100089 [4]联影中央研究院,上海201807

出　　处：《实用放射学杂志》2023年第7期1075-1079,共5页Journal of Practical Radiology

基　　金：河南省医学科技攻关计划项目(SBGJ202101002);河南省科技攻关项目(212102310689);河南省医学科技攻关计划联合共建项目(LHGJ20210001);郑州市协同创新重大专项(郑州大学)(20XTZX05015)。

摘　　要：目的比较扩散峰度成像(DKI)与指数表观扩散系数(eADC)和代谢参数在评估肺腺癌增殖状态中的价值。方法选取52例行正电子发射断层显像/磁共振成像(PET/MRI)检查和病理免疫组化分析的肺腺癌患者,测量肿瘤平均扩散峰度(MK)、平均扩散系数(MD)、平均标准化摄取值(SUVmean)和eADC。比较高Ki-67(>25%)和低Ki-67(≤25%)2组间的各参数值,采用受试者工作特征(ROC)曲线评价其诊断阈值及效能。DeLong检验分析各参数曲线下面积(AUC)的差异。结果高Ki-67组的MK、SUVmean和eADC值显著高于低Ki-67组。MK、eADC、SUVmean和多参数联合(SUVmean+eADC+MK)的AUC分别为0.819、0.698、0.669和0.832。多参数联合与SUVmean或eADC之间的AUC差异有统计学意义。MK、eADC和SUVmean与Ki-67均呈正相关。结论MK、eADC和SUVmean在评价肺腺癌Ki-67表达的效果相似,三者联合可提高评价肺腺癌Ki-67表达的诊断效率。Objective To compare diffusion kurtosis imaging(DKI)and exponential apparent diffusion coefficients(eADC)with metabolic parameters in evaluating the proliferative status of lung adenocarcinoma.Methods A total of 52 patients with lung adenocarcinoma who underwent positron emission tomography/magnetic resonance imaging(PET/MRI)examination and pathological immunohistochemical analysis were selected,and the tumor mean kurtosis(MK),mean diffusivtiy(MD),mean standardized uptake value(SUVmean),and eADC were measured.The values of each parameter were compared between the high Ki-67(>25%)and low Ki-67(<25%)groups,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic threshold and efficacy.The area under the curve(AUC)for each parameter was analyzed by the DeLong test.Results The MK,SUVmean,and eADC values were significantly higher in the high Ki-67 group than those in the low Ki-67 group.The AUC of MK,eADC,SUVmean,and multiparametric combination(SUVmean+eADC+MK)were 0.819,0.698,0.669,and 0.832,respectively.The difference in AUC between multiparametric combination and SUVmeano or eADC was statistically significant.MK,eADC,and SUV,were positively correlated with Ki-67.Conclusion MK,eADC,and SUVmean have similar effects in evaluating Ki-67 expression in lung adenocarcinoma,and the combination of these three parameters can improve the diagnostic efficiency of evaluating Ki-67 expression in lung adenocarcinoma.

关 键 词：正电子发射断层显像 磁共振成像 扩散峰度成像 肺腺癌 KI-67 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学] R734.2[医药卫生—临床医学]