磁共振弥散成像的ADC直方图对子宫内膜癌分级分期及Ki⁃67表达的评估价值  

The Evaluation Value of ADC Histogram in Magnetic Resonance Diffusion Imaging for the Grading,Staging,and Ki⁃67 Expression of Endometrial Cancer

作　　者：曹蕾 杨立赟 田浩[1] 李敏达[1] 赵金丽[1] CAO Lei;YANG Liyun;TIAN Hao;LI Minda;ZHAO Jinli(Department of Imaging,Affiliated Hospital of Nantong University;Department of Radiology,Haimen District Hospital of Traditional Chinese Medicine)

机构地区：[1]南通大学附属医院影像科 [2]南通市海门区中医院放射科

出　　处：《中国医学计算机成像杂志》2024年第1期80-85,共6页Chinese Computed Medical Imaging

基　　金：南通市社会民生科技项目(MS12021102)。

摘　　要：目的:分析磁共振弥散表观弥散系数(ADC)直方图参数与子宫内膜癌的病理分级、分期及Ki⁃67表达的相关性,探讨ADC直方图的应用价值。方法:南通大学附属医院2016年1月至2022年10月的110例子宫内膜癌患者纳入研究,术前完成3 T磁共振弥散成像并由工作站获取ADC图,术后均有病理分级、分期以及Ki⁃67表达水平。Mann⁃Whitney U检验用于评估不同组之间ADC直方图参数的差异。通过Pearson相关分析评估Ki⁃67表达与ADC直方图参数之间的相关性。使用受试者工作特征(ROC)曲线分析评估不同组间差异参数的诊断性能。结果:(1)子宫内膜癌病理高、中、低分化组的ADCmean、ADCske和ADCkur分别为(1.37±0.53)×10^(-3)mm^(2)/s、1.36±0.52、1.70±0.64,(0.92±0.50)×10^(-3)mm^(2)/s、0.92±0.51、1.10±0.54,(0.73±0.40)×10^(-3)mm^(2)/s、0.73±0.41、0.86±0.41;国际妇产科联盟(FIGO)分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期的ADCmean、ADCske、ADCkur分别为(1.38±0.53)×10^(-3)mm^(2)/s、0.11±0.69、0.38±1.79,(1.01±0.49)×10^(-3)mm^(2)/s、0.15±0.73、0.36±1.33,(0.74±0.40)×10^(-3)mm^(2)/s、0.06±0.47、0.59±0.55,(0.56±0.29)×10^(-3)mm^(2)/s、0.07±0.47、0.52±0.57。不同级及不同分期肿瘤之间的ADC直方图参数存在统计学差异。淋巴结阳性及阴性组的ADCmean、ADCske、ADCkur分别为(0.62±0.25)×10^(-3)mm^(2)/s、0.01±0.56、0.56±0.59,(1.14±0.55)×10^(-3)mm^(2)/s、0.03±0.72、0.28±1.46。淋巴结阳性组ADC参数显著低于淋巴结阴性组。(2)ADCmean、ADC10th、ADC50th、ADC90th和Ki⁃67表达之间存在显著的负相关。(3)在盆腔淋巴结阳性组与阴性组的ROC曲线分析中,ADCmean、ADC10th、ADC50th、ADC90th的曲线下面积(AUC)分别为0.816、0.776、0.803、0.834,ADC90th的AUC与ADC10th、ADC50th间有统计学差异。结论:ADC直方图定量参数有助于预测子宫内膜癌的分级、分期和淋巴结转移,也有助于肿瘤Ki⁃67表达的评估。Purpose:To analyze the correlation between the parameters of magnetic resonance apparent diffusion coefficient(ADC)histogram and the pathological grading,staging,and Ki-67 expression of endometrial cancer,and to explore the application value of ADC histogram.Method:A total of 110 patients with endometrial cancer in the Affiliated Hospital of Nantong University from January 2016 to October 2022 were included in the study.Prior to surgery,3 T magnetic resonance diffusion imaging was completed and ADC images were obtained from the workstation.Postoperative pathological grading,staging,and Ki-67 expression levels were observed.The Mann-Whitney U test is used to evaluate the differences in ADC histogram parameters between different groups.The correlation between Ki-67 expression and ADC histogram parameters was evaluate through Pearson correlation analysis.The diagnostic performance of differential parameters between different groups was evaluated using receiver operating characteristics(ROC)curve analysis.Result:(1)The ADCmean,ADCske,and ADCkur in the high,medium,and low differentiation groups of endometrial cancer were(1.37±0.53)×10^(-3)mm^(2)/s,1.36±0.52,1.70±0.64;(0.92±0.50)×10^(-3)mm^(2)/s,0.92±0.51,1.10±0.54;(0.73±0.40)×10^(-3)mm^(2)/s,0.73±0.41,0.86±0.41,respectively.The ADCmean,ADCske,and ADCkur for International Federation of Gynecology and Obstetrics(FIGO)stagesⅠ,Ⅱ,Ⅲ,andⅣwere(1.38±0.53)×10^(-3)mm^(2)/s,0.11±0.69,0.38±1.79;(1.01±0.49)×10^(-3)mm^(2)/s,0.15±0.73,0.36±1.33;(0.74±0.40)×10^(-3)mm^(2)/s,0.06±0.47,0.59±0.55;(0.56±0.29)×10^(-3)mm^(2)/s,0.07±0.47,0.52±0.57),respectively.There were statistical differences in ADC histogram parameters between different grades and stages of tumors.The ADCmean,ADCske,and ADCkur of the lymph node positive and negative groups were(0.62±0.25)×10^(-3)mm^(2)/s,0.01±0.56,0.56±0.59;(1.14±0.55)×10^(-3)mm^(2)/s,0.03±0.72,0.28±1.46,respectively.The ADC parameters of the lymph node positive group were significantly lower than those of the l

关 键 词：子宫内膜癌 磁共振成像 表观弥散系数 直方图分析 Ki⁃67 

分 类 号：R445.2[医药卫生—影像医学与核医学]