基于复合灵敏度编码扩散加权成像表观扩散系数直方图参数评估宫颈癌淋巴结转移  

Evaluation of apparent diffusion coefficient histogram parameters based on multiplexed sensitivity encoding diffusion weighted imaging in lymph node metastasis of cervical cancer

作　　者：白男男 叶彤 孟铁豹 张蔚菁 何浩强[1] 谢传淼[1] BAI Nannan;YE Tong;MENG Tiebao;ZHANG Weijing;HE Haoqiang;XIE Chuanmiao(Department of Radiology,Sun Yat-Sen University Cancer Center,Guangzhouu510060,China;the Brain Cognition and Brain Disease Institute,Shenzhen Institute of Advanced Technology,Chinese Academy of Sciences,Shenzhen,Guangdong Province 518055,China)

机构地区：[1]中山大学肿瘤防治中心影像科,广东广州510060 [2]中国科学院深圳先进技术研究院脑认知与脑疾病研究所,广东深圳518055

出　　处：《实用放射学杂志》2024年第9期1476-1479,共4页Journal of Practical Radiology

摘　　要：目的 探讨基于复合灵敏度编码扩散加权成像(MUSE-DWI)的表观扩散系数(ADC)直方图参数评估宫颈癌(CC)淋巴结转移的应用价值.方法 回顾性分析54例经广泛性全子宫切除术和盆腔淋巴结清扫术后病理确诊的CC患者,提取淋巴结74枚,其中转移性淋巴结28枚,非转移性淋巴结46枚.所有患者术前均接受MRI常规检查及MUSE-DWI扫描,通过参考T_(2)WI压脂图像,在MUSE-DWI的b=800 s/mm^(2)图像上勾画淋巴结感兴趣区(ROI),获得ADC直方图参数:最小值、最大值、均值、中位数、百分位数(第10、第25、第75、第90)、峰度和偏度.对比ADC直方图各参数在转移性淋巴结和非转移性淋巴结之间的差异,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),评价不同参数对鉴别淋巴结转移的诊断效能.结果 转移性淋巴结的ADC直方图均值、中位数、第25百分位数和第75百分位数显著低于非转移性淋巴结(P<0.05).而最小值、最大值、第10百分位数、第90百分位数、峰度和偏度均无统计学差异(P>0.05).在评价各参数鉴别淋巴结转移中,均值的诊断效能最高(AUC=0.718),当阈值为963.07×10^(-6)mm^(2)/s时,敏感度及特异度分别为0.643、0.717.结论 基于MUSE-DWI的ADC直方图参数对鉴别CC淋巴结转移具有较高的诊断价值,其中均值的诊断效能最高.Objective To investigate the application value of apparent diffusion coefficient(ADC)histogram parameters of multi-plexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)in evaluating lymph node metastasis of cervical cancer(CC).Methods A total of 54 patients with CC diagnosed pathologically after extensive hysterectomy and pelvic lymph node dissection were analyzed retrospectively,and 74 lymph nodes were extracted,including 28 metastatic lymph nodes and 46 non-metastatic lymph nodes.All patients underwent routine MRI examination and MUSE-DWI before surgery.Through the T_(2)WI fat suppression images were referenced,the region of interest(ROI)covering the entire lymph nodes were drawn on the b=800 s/mm^(2)images of MUSE-DWI,and ADC histogram parameters were obtained including minimum,maximum,mean,median,percentiles(10 th,25 th,75 th,90 th),kurtosis,and skewness.The differences of ADC histogram parameters between the metastatic lymph nodes and the non-metastatic lymph nodes were compared.The receiver operating characteristic(ROC)curves were drawn and the area under the curve(AUC)were calculated to evaluate the diagnostic efficacy of different parameters in distinguishing lymph node metastasis.Results The mean,median,25 th and 75 th percentiles of ADC histogram of the metastatic lymph nodes were significantly lower than those of the non-metastatic lymph nodes(P<0.05).However,there were no statistically significant differences in minimum,maximum,10 th percentile,90 th percentile,kurtosis,and skewness(P>0.05).In the evaluation of various parameters for distinguishing lymph node metastasis,the mean had the highest diagnostic efficacy(AUC=0.718),and when the threshold was 963.07×10^(-6)mm^(2)/s,the sensitivity and specificity were 0.643 and 0.717,respectively.Conclusion The ADC histogram parameters based on MUSE-DWI have high diagnostic value in differentiating CC lymph node metastasis,and the mean hasthehighest diagnostic efficiency.

关 键 词：磁共振成像 扩散加权成像 宫颈癌 淋巴结转移 直方图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学] R733.4[医药卫生—临床医学]