定量磁化率成像技术在直肠癌病理T分期的初步应用  

Preliminary Application of Quantitative Susceptibility Mapping in the T Staging of Rectal Cancer

作　　者：张海妮 孙小伶 李可可 刘忠啸 王冲 曾建威 孟闫凯 庄银苹 吴鹏 胡春峰 徐凯 ZHANG Haini;SUN Xiaoling;LI Keke;IU Zhongxiao;WANG Chong;ZENG Jianwei;MENG Yankai;ZHUANG Yinping;WU Peng;HU Chunfeng;XU Kai(Department of Radiology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China;School of Medical Imaging,Xuzhou Medical University;Jiangsu Medical Imaging and Digital Medicine Engineering Research Center;School of Medical Technology,Xuzhou Medical University;Philips Healthcare)

机构地区：[1]徐州医科大学附属医院医学影像科,徐州市221000 [2]徐州医科大学医学影像学院 [3]江苏省医学影像与数字医学工程研究中心 [4]徐州医科大学医学技术学院 [5]飞利浦医疗

出　　处：《中国医学计算机成像杂志》2024年第6期703-708,共6页Chinese Computed Medical Imaging

基　　金：江苏省中医药科技发展计划项目(MS2021100);江苏省卫生健康委老年健康科研项目(LKM2022018)。

摘　　要：目的:探讨定量磁化率成像(QSM)技术在直肠癌T分期中的初步应用价值。方法:回顾性分析2022年10月—2023年10月在我院行直肠MRI检查的41例直肠癌患者资料。所有患者均使用3.0 T MR扫描仪进行检查。使用运行在MATLAB version 2018b的STI_Suite V3.0软件包对QSM原始图像进行处理,得到QSM加权图像。将QSM加权图像导入FireVoxel build 394D软件进行图像分割。由一名从事直肠癌研究20年的高级职称医生,在QSM图像上选取肿瘤外侵的最大层面,参照同层面T2WI图像分割肿瘤组织。软件自动计算出肿瘤组织的磁化率直方图参数。由一名从事直肠癌研究方向10年的病理科高级职称医生,参照美国肿瘤联合会结直肠癌分期系统(第8版)评估肿瘤pT分期。采用SPSS 26.0统计软件进行数据分析。组间磁化率差异比较,采用Mann-Whitney U检验。采用受试者工作特征(ROC)曲线评估组织磁化率对pT分期的诊断效能。结果:41例直肠癌患者中,pT1-2期17例(39%),pT3-4期病例24例(61%)。磁化率中位数(四分位间距)为-0.009(0.073)ppm。T3-4期直肠癌第50、60、70、80、90百分位的顺磁效应明显高于相应的T1-T2期直肠癌[50th:-0.102(0.056)ppm比-0.061(0.010)ppm;60th:-0.048(0.053)ppm比-0.015(0.086)ppm;70th:-0.006(0.057)ppm比0.026(0.083)ppm;80th:0.046(0.063)ppm比0.091(0.096)ppm;90th:0.096(0.085)ppm比0.159(0.110)ppm;均P<0.05]。同时,随着百分位的增加,病灶顺磁性效应降低,逆磁性效应增加。第50、60、70、80、90百分位数磁化率预测直肠癌pT1-2与pT3-4分期的ROC曲线下面积(AUC)值分别为0.684、0.708、0.738、0.743、0.755;灵敏度分别为0.588、0.647、0.824、0.882、0.824;特异度分别为0.875、0.792、0.583、0.583、0.375。结论:基于定量QSM技术的直方图分析在直肠癌T分期中有一定的应用价值。Purpose:To investigate the preliminary application value of quantitative susceptibility mapping(QSM)in the T staging of rectal cancer.Methods:The data of 41 patients with rectal cancer who underwent rectal MRI examinations in our hospital from October 2022 to October 2023 were retrospectively analyzed.All patients were examined using a 3.0 T MR Scanner.QSM images were processed using the STI_Suite V3.0 software running on MATLAB version 2018b to obtain QSM-weighted images.The QSM-weighted images were imported into Fire Voxel build 394D software for image segmentation.A senior radiologist with over 20 years of experience in rectal MRI diagnosis marked the layer of the maximum tumor invasion on QSM-weighted images and segmented the tumor tissue with reference to T2WI images at the same layer.The software automatically calculated the susceptibility histogram parameters of tumor tissue.Tumor staging was evaluated by a senior pathologist with 10 years of experience in rectal cancer diagnosis,according to the 8th edition of the American Joint Committee on Cancer(AJCC)Cancer Staging Manual for Colorectal Cancer.SPSS 26.0 statistical software was used for data analysis.Mann-Whitney U test was used to compare the difference of susceptibility between groups.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of tissue susceptibility for p T staging.Results:Among the 41 cases of patients with rectal cancer,17 cases(39%)were p T1-2 stage and 24 cases(61%)were p T3-4 stage.The median(interquartile range)of susceptibility was-0.009(0.073)ppm.The paramagnetic effects of 50th,60th,70th,80th and 90th percentile of p T3-4 stage rectal cancer were significantly higher than those of p T1-2 stage rectal cancer[50th:-0.102(0.056)ppm vs-0.061(0.010)ppm;60th:-0.048(0.053)ppm vs-0.015(0.086)ppm;70th:-0.006(0.057)ppm vs 0.026(0.083)ppm;80th:0.046(0.063)ppm vs 0.091(0.096)ppm;90th:0.096(0.085)ppm vs 0.159(0.110)ppm,all P<0.05].At the same time,as the percentile increased,the paramagnetic effect of t

关 键 词：直肠肿瘤 磁共振成像 定量磁化率成像 直方图分析 磁敏感加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]