DCE-MRI联合IVIM-DWI诊断宫颈癌淋巴结转移的价值研究  

The Value of DCE-MRI Combined with IVIM-DWI in the Diagnosis of Cervical Cancer Lymph Node Metastasis

作　　者：王佳[1] 牛俊巧[1] 李晓娟 刘焱[1] WANG Jia;NIU Jun-qiao;LI Xiao-juan;LIU Yan(Radiological Imaging Center of People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,新疆乌鲁木齐830001

出　　处：《中国CT和MRI杂志》2024年第10期114-117,共4页Chinese Journal of CT and MRI

基　　金：新疆维吾尔自治区自然科学基金资助项目(2021D01C211);新疆维吾尔自治区人民医院院内基金资助项目(20200210)。

摘　　要：目的 分析动态增强磁共振成像(DCE-M RI)联合体素内不相干运动扩散加权成像(IVIM-DWI)对宫颈癌淋巴结转移的预测价值,为宫颈癌淋巴结转移的诊治提供参考依据。方法回顾性纳入2021年6月-2023年6月收治于新疆维吾尔自治区人民医院并经病理确诊的103例宫颈癌患者临床资料进行分析,根据是否发生盆腔淋巴结转移分为转移组(26例)和未转移组(77例)。于根治性子宫切除术前对患者进行DCE-MRI和IVIM-DWI检查,获取相关检查参数[DCE-MRI参数包括容量转运常数(K^(trans))、速率常数(K_(ep))、血管外间隙容积分数(V_(e)),IVIM-DWI参数包括表观扩散系数(ADC)、纯扩散系数(D)、伪扩散系截(D^(*))和灌注分数(f)],对比两组DCE-MRI和IVIMDWI参数的差异性,绘制受试者工作特征(ROC)曲线分析DCE-MRI联合IVIM-DWI对宫颈癌淋巴结转移的预测价值。结果在IVIM-DW参数中,转移组D值低于未转移组,f值高于未转移组(P<0.05);两组ADC、D^(*)值比较无显著性差异(P>0.05)。在DCEMRI参数中,转移组K^(trans)、V_(e)值均高于未转移组(P<0.05);两组K_(ep)值比较无显著性差异(P>0.05)。绘制ROC曲线显示,D、f、K^(trans)、V_(e)单独预测宫颈癌淋巴结转移的价值中等,曲线下面积(AUC)分别为0.842、0.749、0.785、0.828,特异度分别为0.714、0.688、0.662、0.766,敏感度分别为0.846、0.731、0.846、0.731;而各参数联合对宫颈癌淋巴结转移的预测价值较高,AUC为0.959,特异度为0.883,敏感度为0.923。结论DCE-MRI与IVIM-DWI检查获取的D、f、K^(trans)、V_(e)等参数均是预测宫颈癌淋巴结转移的理想指标,且上述参数联合对宫颈癌淋巴结转移具有更高的预测价值。Objective To analyze the predictive value of dynamic enhancedmagnetic resonance imaging(DCE-MRI)com bined with intravoxel incoherentmotion diffusion-weighted imaging(IVIM-DWI) for cervical cancer lymph node metastasis,and to provide reference for the diagnosis and treatment of cervical cancer lymph node metastasis.Methods A retrospective analysis was conducted on the clinical data of 103 cervical cancer patients admitted to our hospital from June 2021 to June 2023 and confirmed by pathology.They were divided into a metastatic group(26 cases) and a non metastatic group(77 cases) based on whether pelvic lymph node metastasis occurred.DCE-MRI and IVIM-DWI were performed before radical hysterectomy to obtain relevant exa mination parameters [DCE-MRI parameters included volume transfer consta nt(K^(trans)),rate constant(K_(ep)),ext ravascular space volume fraction(Ve),IVIM-DWI parameters included apparent diffusion coefficient(ADC),pure diffusion coefficient(D),pseudo-diffusion coefficient(D~*) and perfusion fraction(f)].The differences of DCE-MRI and IVIM-DWI parameters between the two groups were compared,and the receiver operating cha racteristic(ROC) curve was drawn to analyze the predictive value of DCE-M RI com bined with IVIM-DWI for lymph node metastasis of cervical cancer.Results In the IVIMDW parameters,the D value of the metastatic group was lower than that of the non metastatic group,and the f value was higher than that of the non metastatic group(P<0.05).There was no significa nt difference in ADC and D~* values between the two groups(P>0.05).In the DCE-MRI parameters,the K^(trans) and Ve values in the metastatic group were higher than those in the non metastatic group(P<0.05).There was no significant difference in K_(ep) values between the two groups(P>0.05).ROC curve showed that D,f,K^(trans) and V_(e) had moderate value in predicting lymph node metastasis of cervical cancer alone.The area under the curve(AUC) was 0.842,0.749,0.785 and 0.828,the specificity was 0.714,0.688,0.662 and 0.766,and the sensit

关 键 词：宫颈癌 盆腔淋巴结转移 动态增强磁共振成像 体素内不相干运动扩散加权成像 

分 类 号：R711.74[医药卫生—妇产科学]