表观扩散系数在预测肝泡状棘球蚴病肺转移的临床价值  

The Clinical Value of Apparent Diffusion Coefficient in Predicting Pulmonary Metastasis of Hepatic Alveolar Echinococcosis

作　　者：张雪倩 鲍海华[1] 丹增耶昂 龙昌友 田鹏启 邢玉洁 ZHANG Xueqian;BAO Haihua;DAN Zengyeang(Image center,Qinghai University Affiliated Hospital,Xining,Qinghai Province 810001,P.R.China)

机构地区：[1]青海大学附属医院影像中心,西宁810001 [2]武汉大学,武汉430000

出　　处：《临床放射学杂志》2025年第4期743-748,共6页Journal of Clinical Radiology

基　　金：国家临床重点专科建设项目(青卫键办[2024]90号)。

摘　　要：目的 探索表观扩散系数(ADC)在预测肝泡状棘球蚴病(HAE)肺转移方面的潜在价值和可行性。方法 回顾性搜集在青海大学附属医院2015年到2024年确诊为HAE患者的影像学特征及临床指标,并计算其联合指标。在ADC图上分别测量病灶最大层面实性部分与边缘带的ADC最小值(ADC_(min))、ADC最大值(ADC_(max))及ADC平均值(ADC_(mean))。比较无转移HAE患者与肺转移HAE患者病灶实性部分及边缘带ADC值的差异,绘制受试者工作特征(ROC)曲线,分析ADC在预测HAE肺转移的价值。结果 共纳入147例HAE患者,平均年龄(36.88±1.2)岁,男60例,女87例。HAE发生肺转移组的边缘带ADC_(max)、ADC_(min)、ADC_(mean)均低于无转移组,差异有统计学意义(P均<0.05)。实性部分ADC_(max)、ADC_(min)、ADC_(mean)在肺转移组与无转移组间差异无统计学意义(P均>0.05)。两组病灶中边缘带ADC_(max)、ADC_(min)、ADC_(mean)均低于实性成分ADC_(max)、ADC_(min)、ADC_(mean)。ROC结果显示边缘带ADC_(min)、ADC_(max)、ADC_(mean)及联合指标均能有效地预测HAE肺转移的发生,其中联合指标具有最佳效能,其最佳截止值为0.489,相应曲线下面积(AUC)、灵敏度、特异度分别为0.812[95%可信区间(CI)0.739~0.871]、77.55%(95%CI 63.4%~88.2%)、69.39%(95%CI 59.3%~78.3%)。结论 病灶边缘带的ADC能够有效地预测HAE肺转移,有利于临床医师及时掌握疾病的进展状况,并能够为患者制定个体化的治疗方案提供有力支持。Objective To investigate the potential value and feasibility of using the apparent diffusion coefficient value in predicting pulmonary metastasis in hepatic alveolar echinococcosis(HAE).Methods The imaging characteristics and clinical parameters of patients diagnosed with HAE at Qinghai University Affiliated Hospital between 2015 and 2024 were retrospectively collected,and their combined indicators were calculated.Measure the minimum ADC value(ADC_(min)),the mean ADC value(ADC_(mean)),and the max ADC value(ADC_(max)) of the parenchymal area and the edge zone of the largest lesion slice on the ADC map.Compare the differences in ADC values between the parenchymal area and edge zones of lesions in patients with HAE without metastasis and those with pulmonary metastasis of HAE.,and the receiver operating characteristic(ROC) curves were drawn.Then,analyze the efficiency of apparent diffusion coefficient in predicting pulmonary metastasis of hepatic alveolar echinococcosis was analyzed.Results A total of 147 patients with HAE(mean age 36.88±1.2 years,60 males and 87 females) were included,and the details of each parameter are shown in the table below.The ADC_(max),ADC_(min),and ADC_(mean) of the edge zone in the group with pulmonary metastasis of HAE were lower than those in the group without metastasis,and the differences were statistically significant(P<0.05).There was no statistically significant difference in ADC_(max),ADC_(min),and ADC_(mean) of the parenchymal area between the group with pulmonary metastasis of HAE and the group without metastasis(P>0.05).In both groups,the ADC_(max),ADC_(min),and ADC_(mean) of the edge zone were lower than those of the parenchymal area.The ROC results showed that each ADC value of the edge zone and joint index could effectively predict the occurrence of pulmonary metastasis of hepatic alveolar echinococcosis,with joint index having the best predictive power.The optimal cut-off value was 0.489,and the corresponding area under the curve(AUC),sensitivity,and specificity were 0.812

关 键 词：肝泡状棘球蚴病 肺转移 表观扩散系数 预测 

分 类 号：R73[医药卫生—肿瘤]