MR体素内不相干运动定量参数对肛瘘活动性的评价  

The evaluation of the activity of anal fistulas by quantitative parameters of MR intravoxel incoherent motion

作　　者：熊炬 曹阳 葛孟 冷欢 刘烨 李咏梅[1] XIONG Ju;CAO Yang;GE Meng;LENG Huan;LIU Ye;LI Yong-mei(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Radiology,Dianjiang County People's Hospital,Chongqing 408300,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]重庆市垫江县人民医院放射科,重庆408300

出　　处：《中国临床医学影像杂志》2024年第8期567-571,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨体素内不相干运动扩散加权成像(IVIM-DWI)的定量参数在肛瘘活动性评估中的价值。方法:收集75例肛瘘患者的术前MRI图像及临床资料,获取IVIM-DWI序列(b=0、50、100、150、200、300、600、1 000、1 500、2 000 s/mm^(2))的定量参数,包括:真实扩散系数(D)、假扩散系数(D*)、灌注分数(f)。以肛周疾病活动指数(PDAI)为诊断标准将上述患者分为活动性组(n=51)和非活动性组(n=24)。比较两组患者IVIM-DWI定量参数的差异,并采用受试者工作特征曲线(ROC)计算上述定量参数的诊断效能。结果:活动组和非活动组的D值分别为(0.27±0.20)×10-3mm2/s 和(0.52±0.18)×10^(-3)mm^(2)/s,差异有统计学意义(P=0.000);D*值分别为0.10(0.08,0.15)×10^(-2)mm^(2)/s和0.10(0.08,0.14)×10^(-2)mm^(2)/s,差异无统计学意义(P=0.730);f值分别为0.29±0.07和0.26±0.07,差异无统计学意义(P=0.710)。ROC曲线分析显示D值预测肛瘘活动性的曲线下面积(AUC)为0.900,敏感性和特异性分别为86.3%、79.2%,最佳诊断阈值为0.37×10^(-3)mm^(2)/s。结论:IVIM-DWI定量参数的D值有助于术前无创性地评价肛瘘的活动性。Objective:To investigate the value of quantitative parameters of intravoxel incoherence motion diffusion weight-ed imaging(IVIM-DWI)in noninvasive preoperative prediction of anal fistula activity.Methods:Preoperative MRI images and clinical data of 75 patients with anal fistula were collected,quantitative parameters of IVIM-DWI sequence(b=0,50,100,150,200,300,600,1000,1500,2000 s/mm)were obtained.It includes diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(f).According to perianal disease activity index(PDAI),the patients were divided into active group and inactive group.The difference of IVIM-DWI quantitative parameters between the two groups were compared,and the diagnos-tic efficacy of the above quantitative parameters was calculated by receiver operating characteristic curve(ROC).Results:The D values of active group and inactive group were(0.27±0.20)×10^(-3)mm^(2)/s and(0.52±0.18)×10^(-3)mm^(2)/s respectively,and the dif-ference was statistically significant(P=0.000).The D*values were 0.10(0.08,0.15)×10^(-2) mm^(2)/s and 0.10(0.08,0.14)×10^(-2) mm^(2)/s respectively,with no statistical significance(P=0.730).The f values were 0.29±0.07 and 0.26±0.07 respectively,with no statisti-cal significance(P=0.710).ROC curve analysis showed that the area under the curve(AUC)of D value in predicting anal fistula activity was 0.900,the sensitivity and specificity were 86.3%and 79.2%respectively,and the optimal diagnostic threshold was 0.37×10^(-3)mm^(2)/s.Conclusion:The D value of IVIM-DWI is helpful to noninvasively predict the activity of anal fistulas before operation.

关 键 词：直肠瘘 磁共振成像 

分 类 号：R574.8[医药卫生—消化系统] R445.2[医药卫生—内科学]