磁共振IDEAL-IQ和体素内不相干运动预测子宫内膜癌细胞增殖状态  

Application of IDEAL-IQ and intravoxel incoherent motion in assessing the proliferation status of endometrial carcinoma

作　　者：周凤梅[1] 任继鹏[1] 翟战胜[1] 段金辉 刘旺毅 殷慧佳 ZHOU Fengmei;REN Jipeng;ZHAI Zhansheng;DUAN Jinhui;LIU Wangyi;YIN Huijia(Department of Magnetic Resonance,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院磁共振科,河南新乡453100

出　　处：《肿瘤影像学》2023年第6期542-548,共7页Oncoradiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210498)。

摘　　要：目的:探索磁共振成像多点非对称回波采集与迭代最小二乘法水脂分离(iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence,IDEAL-IQ)和体素内不相干运动(intravoxel incoherent motion,IVIM)在子宫内膜癌(endometrial carcinoma,EC)细胞增殖状态评估中的价值。方法:回顾并分析24例Ki-67增殖指数低(≤50%)和19例Ki-67增殖指数高(>50%)的EC患者的资料,分别测量病灶IDEAL-IQ成像的脂肪分数(fat fraction,FF)、R_(2)^(*)弛豫率(R_(2)^(*))值和IVIM成像的慢速表观弥散系数(slow apparent diffusion coefficient,ADCslow)、快速表观弥散系数(fast apparent diffusion coefficient,ADC-fast)和灌注分数(perfusion fraction,f)并进行对比。受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under curve,AUC)被用于确定各参数的诊断效能,logistic回归和DeLong检验分别被用于多参数联合诊断和不同AUC间的差异分析。Spearman相关被用于评估各参数值与Ki-67增殖指数的相关性。结果:Ki-67增殖指数高的组ADC-slow、ADC-fast和R_(2)^(*)值均显著低于Ki-67增殖指数低的组(P分别为<0.001、0.004、<0.001)。ADC-slow、ADC-fast、R_(2)^(*)以及三者联合鉴别Ki-67增殖指数高、低组EC的AUC分别为0.860、0.748、0.862和0.978。DeLong分析显示,ADC-slow+ADC-fast+R_(2)^(*)与ADC-slow、ADC-fast及R_(2)^(*)之间的AUC差异均有统计学意义(Z分别为2.109、3.134、2.227;P分别为0.035、0.002、0.023)。ADC-slow和R_(2)^(*)值均与Ki-67增殖指数呈中度负相关(r分别为-0.547、-0.711,P<0.001),ADC-fast与Ki-67增殖指数呈轻度负相关(r分别为-0.324,P=0.034)。结论:ADC-slow、ADC-fast和R_(2)^(*)均有助于评估EC患者的细胞增殖状态,且三者联合能够对Ki-67增殖指数高、低组EC进行更有效的鉴别。Objective:To investigate the application of iterative decomposition of water and fat with echo asymmetry and the least squares estimation quantification sequence(IDEAL-IQ)and intravoxel incoherent motion(IVIM)in assessing the proliferation status of endometrial carcinoma(EC).Methods:The data of 24 EC patients with low Ki-67 proliferation index(≤50%)and 19 EC patients with high Ki-67 proliferation index(>50%)were retrospectively analyzed,and lesions’fat fraction(FF)and R_(2)^(*)values of IDEALIQ and slow diffusion coefficient(ADC-slow),fast diffusion coefficient(ADC-fast)and perfusion fraction(f)values of IVIM were measured and compared.The area under the receiver operating characteristic(ROC)curve(AUC)was used to determine the diagnostic efficacy of each parameter,and logistic regression and DeLong tests were used for multiparameter combined diagnosis and analysis of variance between AUCs,respectively.The Spearman correlation was used to assess the correlation of each parameter value with Ki-67 proliferation index.Results:The ADC-slow,ADC-fast and R_(2)^(*)values were significantly lower in the high Ki-67 proliferation index group than in the low Ki-67 group(P were<0.001,0.004,<0.001,respectively).The AUCs for ADC-slow,ADC-fast,R_(2)^(*),and the combination of the three to identify high and low Ki-67 proliferation index groups EC were 0.860,0.748,0.862,and 0.978,respectively,and DeLong analysis showed that the differences of AUC between ADC-slow+ADC-fast+R_(2)^(*)and ADC-slow,ADCfast,and R_(2)^(*)were all statistically significant(Z=2.109,3.134,and 2.227;P=0.035,0.002,and 0.023,respectively).Both ADC-slow and R_(2)^(*)values were moderately negatively correlated with Ki-67 proliferation index(r=-0.547,-0.711,P<0.001)and ADC-fast was mildly negatively correlated with Ki-67 proliferation index levels(r=-0.324,P=0.034).Conclusion:ADC-slow,ADC-fast,and R_(2)^(*)are all useful in assessing the proliferative status of cells in EC patients,and the combination of the three can able to discriminate more effectively be

关 键 词：子宫内膜癌 磁共振成像 Ki-67增殖指数 多点非对称回波采集与迭代最小二乘法水脂分离 体素不相干运动 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]