IVIM成像参数及细胞外体积分数对非小细胞肺癌病理类型及淋巴结转移状态预测的应用价值  

Application values of intravoxel incoherent motion imaging parameters and extracellular volume fraction in assessment of pathological types and prediction of lymph node metastasis status of non-small cell lung cancer

作　　者：韩慧芝 郭文秀 任红 郝慧婷 田迷迷 辛家祥 刘孟潇 林祥涛 赵鹏 Han Huizhi;Guo Wenxiu;Ren Hong;Hao Huiting;Tian Mimi;Xin Jiaxiang;Liu Mengxiao;Lin Xiangtao;Zhao Peng(Department of Radiology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;MR Research Collaboration Team,Diagnostic Imaging,Siemens Healthineers Ltd,Shanghai 200126,China)

机构地区：[1]山东第一医科大学附属省立医院医学影像科,济南250021 [2]西门子医疗系统有限公司磁共振科研合作部门,上海200126

出　　处：《中华解剖与临床杂志》2024年第12期789-796,共8页Chinese Journal of Anatomy and Clinics

基　　金：山东省自然科学基金(ZR2021MH216)。

摘　　要：目的探讨MR体素内不相干运动(IVIM)成像参数及细胞外体积分数(ECV)在非小细胞肺癌(NSCLC)病理类型(腺癌与鳞癌)评估以及淋巴结转移状态预测中的应用价值。方法横断面研究。纳入2021年9月—2023年8月在山东第一医科大学附属省立医院经病理确诊的NSCLC患者81例,其中男63例、女18例,年龄39~77(60.9±8.1)岁。根据病理类型将患者分为腺癌组47例和鳞癌组34例,根据有无淋巴结转移分为转移组42例和无转移组39例。患者均行MR常规序列扫描、缩放成像技术(ZOOMit)IVIM及增强T_(1) mapping成像。测量表观弥散系数(ADC)、真弥散系数(D)、伪弥散系数(D^(*))、灌注分数(f)等IVIM参数及增强前后T_(1)值,计算ECV。观察指标:(1)比较腺癌组与鳞癌组、转移组与无转移组患者的性别、年龄、病灶大小、肿瘤分化程度等一般资料;(2)使用组内相关系数(ICC)评价不同观察者间测量结果的一致性;(3)分析IVIM参数及ECV在腺癌组与鳞癌组、转移组与无转移组之间的差异;(4)评价并比较IVIM参数及ECV对NSCLC病理分型的诊断及对有无淋巴结转移的预测效能。结果(1)腺癌组与鳞癌组比较,患者年龄、病灶大小、肿瘤分化程度差异均无统计学意义(P值均>0.05),性别构成差异有统计学意义(χ^(2)=6.09,P=0.014)。转移组与无转移组比较,患者性别、年龄、病灶大小、肿瘤分化程度、病理类型差异均无统计学意义(P值均>0.05)。(2)不同观察者间测量的各IVIM参数及ECV值均具有较高一致性(ICC值为0.789~0.879)。(3)腺癌组D^(*)、f分别为(1610.91±520.14)×10^(-3)mm^(2)/s、26.39%±4.02%,高于鳞癌组的(1349.45±508.34)×10^(-3)mm^(2)/s、21.96%±4.07%,差异均有统计学意义(t=2.25、4.87,P值均<0.05);2组间ADC、D及ECV比较差异均无统计学意义(P值均>0.05)。转移组D^(*)、f及ECV分别为(1635.76±513.04)×10^(-3)mm^(2)/s、26.15%±4.13%及0.34±0.05,均高于无转移组的(1356.20±511.67)×10^(-3Objective This study aimed to investigate the value of intravoxel incoherent motion imaging(IVIM)parameters and extracellular volume fraction(ECV)in the diagnosis of pathological types(adenocarcinoma and squamous cell carcinoma)and the prediction of lymph node metastasis status of non-small cell lung cancer(NSCLC).Methods A cross-sectional study was performed,and the data of 81 patients diagnosed with NSCLC by pathological examination from September 2021 to August 2023 in Shandong Provincial Hospital Affiliated to Shandong First Medical University were included.The patients aged 39-77(60.9±8.1)years,and they were composed of 63 males and 18 females.The patients were divided into adenocarcinoma group(47 patients)and squamous carcinoma group(34 patients)in accordance with pathological typing.They were also divided into metastasis group(42 patients)and non-metastasis group(39 patients)in according with the presence or absence of lymph node metastasis.All patients underwent native MR ZOOM imaging technology(ZOOMit)IVIM,native and enhanced T_(1) mapping imaging.The following parameters were measured:apparent diffusion coefficient(ADC),true diffusion coefficient(D),pseudo-diffusion coefficient(D^(*)),perfusion fraction(f),and T_(1) values before and after enhancement.ECV was calculated.Observation indices:(1)The intergroup differences in baseline information,such as gender,age,lesion size,and tumor differentiation degree,between the adenocarcinoma group and the squamous carcinoma group and between the metastasis group and the non-metastasis group were compared.(2)The consistency of the measurements between different observers was evaluated using intragroup correlation coefficient(ICC).(3)The differences between adenocarcinoma and squamous carcinoma groups and between metastasis and non-metastasis groups in terms of IVIM parameters and ECV were analyzed.(4)The diagnostic performance of IVIM parameters and ECV in the pathological classification and lymph node metastasis status of NSCLC were evaluated and compared.Result

关 键 词：癌 非小细胞肺 磁共振成像 病理类型 腺癌 鳞状细胞癌 淋巴结转移 体素内不相干运动 细胞外体积分数 

分 类 号：R734.2[医药卫生—肿瘤]