磁共振分数阶微积分扩散成像在直肠癌分化程度评估中的价值  

The Value of Magnetic Resonance Fractional Order Calculus Diffusion Imaging in the Assessment of Rectal Cancer Differentiation

作　　者：金兴兴 王帅娜 王红霞 王雪佳[1] 闫瑞芳[1] 韩东明[1] JIN Xingxing;WANG Shuaina;WANG Hongxia(Department of Magnetic Resonance,the First Affiliated Hospital of Xinxiang Medical University,Weihui,Henan Province 453100,P.R China)

机构地区：[1]新乡医学院第一附属医院磁共振科,河南卫辉453100

出　　处：《临床放射学杂志》2025年第5期902-906,共5页Journal of Clinical Radiology

基　　金：医学与健康事业研究发展项目-伦琴影像科研专项(编号:HN-20201017-002);河南省高等学校重点科研项目(编号:24B320017);河南省医学科技公关计划联合共建项目(编号:LHGJ20230528)。

摘　　要：目的对比分析磁共振分数阶微积分(FROC)扩散成像模型和单指数扩散加权成像(DWI)模型在直肠癌分化评估中的价值。方法分析36例中-高分化直肠癌患者和24例低分化直肠癌患者的FROC和DWI影像资料,测量病灶的扩散系数(D)、体素内扩散异质性参数(β)、空间参数(μ)和表观扩散系数(ADC)值,并进行组间对比。逻辑回归分析被用于多参数联合诊断,受试者工作特征曲线下面积(AUC)和Delong检验分别被用于诊断性能的评估与对比。结果中-高分化直肠癌组的ADC、D和β值均大于低分化直肠癌组,其μ值小于低分化直肠癌组(P均<0.001)。诊断性能方面,在不同参数中,D值具有最高的诊断性能,其AUC为0.851(95%CI:0.735~0.930)、敏感性为91.67%、特异性为61.11%,且D值与ADC值的AUC之间的差异具有统计学意义(Z=2.188,P=0.034);对于不同成像序列,FROC具有最高的诊断性能,其AUC为0.931(95%CI:0.834~0.980)、敏感性为83.33%、特异性为94.44%,且FROC与DWI(ADC)、β和μ的AUC之间的差异均有统计学意义(Z=3.262、2.243和2.473,P=0.001、0.025和0.013)。结论FROC和DWI均可用于评估直肠癌分化情况,且FROC具有更高的诊断性能。Objective To comparatively analyze the value of the magnetic resonance fractional-order calculus(FROC)diffusion imaging model and the mono-exponential diffusion-weighted imaging(DWI)model in assessing rectal cancer differentiation.Methods FROC and DWI imaging data from 36 patients with moderately and highly differentiated rectal cancer and 24 patients with poorly differentiated rectal cancer were analyzed.The diffusion coefficient(D),intravoxel diffusion heterogeneity parameter(β),spatial parameter(μ),and apparent diffusion coefficient(ADC)values of the lesions were measured and compared between groups.Logistic regression analysis was used for multiparametric combined diagnosis,and the area under the receiver operating characteristic curve(AUC)and DeLong's test were used to assess and compare diagnostic performance.Results The ADC,D,andβvalues were higher in the moderately and highly differentiated rectal cancer group than in the poorly differentiated group,while theμvalue was lower(all P<0.001).In terms of diagnostic performance,the D value had the highest diagnostic performance with an AUC of 0.851(95%CI:0.735-0.930),sensitivity of 91.67%,and specificity of 61.11%.The difference in AUC between the D value and ADC value was statistically significant(Z=2.188,P=0.034).For different imaging sequences,FROC had the highest diagnostic performance with an AUC of 0.931(95%CI:0.834-0.980),sensitivity of 83.33%,and specificity of 94.44%.Statistically significant differences in AUC were observed between FROC and DWI(ADC),β,andμvalues(Z=3.262,2.243,and 2.473,P=0.001,0.025,and 0.013,respectively).Conclusion Both FROC and DWI can be used to assess rectal cancer differentiation,with FROC demonstrating higher diagnostic performance.

关 键 词：分数阶微积分扩散成像 单指数扩散加权成像 直肠癌 分化程度 

分 类 号：R445.2[医药卫生—影像医学与核医学]