摘要
目的本研究旨在探讨MRI多b值弥散加权成像(diffusion weighted imaging,DWI)的相关定量参数对胃癌脉管侵犯的预测效能。材料与方法纳入230例术前接受胃MRI检查并接受根治性胃切除术的胃癌患者,根据术后病理结果将患者分为脉管侵犯阳性组和脉管侵犯阴性组,记录术前影像T分期、N分期、胃癌病灶的厚度、体积及单指数模型(mono-exponential model,MEM)、体素内不相干运动(intravoxel incoherent motion,IVIM)双指数模型、扩散峰度成像(diffusion kurtosis imaging,DKI)和拉伸指数模型(stretched exponential model,SEM)的相关定量参数,采用逻辑回归分析筛选脉管侵犯阳性的独立危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线评估各参数鉴别脉管侵犯状态的效能,同时通过DeLong检验比较各参数效能之间的差异。结果两组患者间的影像T分期、影像N分期、病灶厚度、病灶体积、MEM的表观扩散系数(apparent diffusion coefficient,ADC)、DKI的平均峰度(mean kurtosis,MK)、IVIM的真实扩散系数(diffusion coefficient,D)及伪扩散系数(pseudodiffusion coefficient,D^(*))、SEM的体素内水分子扩散异质性系数(α)差异均有统计学意义(P均<0.05),DKI_MK、影像N分期及二者联合模型的曲线下面积(area under the curve,AUC)分别为0.809[95%置信区间(confidence interval,CI):0.752~0.866]、0.666(95%CI:0.596~0.736)、0.828(95%CI:0.776~0.879)。DKI_MK与联合模型之间差异无统计学意义(P>0.05)。结论MRI多b值DWI定量参数对术前预测胃癌脉管侵犯具有较好的效能。
Objective:To investigate the efficacy of MRI multiple b-value diffusion weighted imaging(DWI)quantitative parameters in predicting lymphovascular invasion of gastric cancer.Materials and Methods:Two hundred and thirty gastric cancer patients who underwent radical gastrectomy and gastric MRI examination before the operation.The patients were divided into positive group and negative group according to postoperative pathological results for lymphorascular invasion.The preoperative image T-staging and image N-staging were evaluated,and the lesion thickness,lesion volume and quantitative parameters of mono-exponential mode(MEM),intravoxel incoherent motion(IVIM),diffusion kurtosis imaging(DKI)and stretched exponential model(SEM)of the patients were measured.Logistic regression analysis was used to screen out independent risk factors with positive lymphovascular invasion,receiver operating characteristic(ROC)curve was used to evaluate the efficacy of each parameter in identifying lymphovascular invasion status,and DeLong test was used to compare the efficacy of each parameter.Results:There were statistical differences in image T-staging,image N-staging,lesion thickness,lesion volume,apparent diffusion coefficient(ADC)of MEM,mean kurtosis(MK)of DKI,diffusion coefficient(D)and pseudodiffusion coefficient(D^(*))of IVIM andαof SEM between two groups(all P<0.05).The area under the curve(AUC)values of DKI_MK,image N-staging and combined models were 0.809[95%confidence interval(CI):0.752 to 0.866],0.666(0.596 to 0.736)and 0.828(0.776 to 0.879),respectively.There was no significant difference between DKI_MK and combined model(P>0.05).Conclusions:MRI multiple b-value DWI quantitative parameters can predict lymphovascular invasion in gastric cancer effectively before operation.
作者
俞文尉
李琼
魏晓雪
桑梓桐
后雅珺
刘希胜
YU Wenwei;LI Qiong;WEI Xiaoxue;SANG Zitong;HOU Yajun;LIU Xisheng(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《磁共振成像》
北大核心
2025年第8期88-94,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金(编号:82071919)
南京医科大学第一附属医院青年培育基金(编号:PY202413)。
关键词
胃癌
磁共振成像
弥散加权成像
脉管侵犯
术前评估
预测
gastric cancer
magnetic resonance imaging
diffusion weighted imaging
lymphovascular invasion
preoperative evaluation
prediction
