摘要
目的探究基于磁共振扩散加权成像(DWI)的虚拟弹性成像(vMRE)对直接手术宫颈癌患者脉管浸润(LVSI)状态的预测效能。方法前瞻性搜集2021年11月至2022年10月于河南省人民医院接受根治性子宫切除术的患者的临床及影像资料。所有患者术前均行盆腔MRI检查,序列包括常规序列及多b值DWI。基于DWI数据生成vMRE图像并提取μ_(diff)参数。依据术后病理结果分为LVSI阳性组和LVSI阴性组,采用t检验或Mann-Whitney U检验比较组间参数的差异,使用Logistics回归分析筛选出与LVSI状态相关的变量,构建预测模型,并绘制受试者工作特征(ROC)曲线,采用受试者工作特征曲线下面积(AUC)评估各模型预测LVSI的效能。结果最终纳入69例宫颈癌患者。临床变量中FIGO分期与LVSI显著相关。LVSI阳性组患者的μ_(diff)平均值、最大值、中位数和最小值均显著高于阴性组(P<0.05)。由μ_(diff)最小值与FIGO分期联合构建的模型的诊断效能最佳,其AUC为0.804、灵敏度为0.756、特异度为0.750、准确率为0.754,优于单一指标模型。结论基于vMRE生成的μ_(diff)值展现了良好的诊断效能,表明该技术对于预测宫颈癌患者手术后LVSI状态具有良好的潜力,可作为一项有价值的临床辅助评估手段。
Objective To explore the predictive efficacy of virtual magnetic resonance elastography(vMRE)based on diffusion-weighted imaging(DWI)for lymphovascular space invasion(LVSI)status in cervical cancer patients undergoing primary surgery.Methods Clinical and imaging data of patients who underwent radical hysterectomy at Henan Provincial People's Hospital from November 2021 to October 2022 were prospectively collected.All patients underwent preoperative pelvic MRI examinations,including conventional sequences and multi-b-value DWI.vMRE images were generated based on DWI data,and μ_(diff)parameters were extracted.Patients were divided into LVSI-positive group and LVSI-negative group according to postoperative pathological results.The t-test or MannWhitney U test was used to compare parameter differences between the two groups.Logistic regression analysis was performed to screen variables associated with LVSI status,and a predictive model was constructed.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was used to evaluate the predictive efficacy of each model for LVSI.Results A total of 69 cervical cancer patients were finally included.Among clinical variables,FIGO stage was significantly correlated with LVSI.The mean,maximum,median,and minimum values of μ_(diff)in the LVSI-positive group were significantly higher than those in the LVSInegative group(P<0.05).The model constructed by combining the minimum μ_(diff)value with FIGO stage showed the best diagnostic efficacy,with an AUC of 0.804,sensitivity of 0.756,specificity of 0.750,and accuracy of 0.754,which was superior to the single-index models.Conclusion The μ_(diff)values generated based on vMRE exhibit good diagnostic efficacy,indicating that this technique has great potential for predicting the postoperative LVSI status of cervical cancer patients and can serve as a valuable clinical auxiliary assessment tool.
作者
杨紫涵
张月洁
刘金金
董林逍
陈洁洁
蒋文亮
樊荣科
吴青霞
吴青霞
王梅云
YANG Zihan;ZHANG Yuejie;LIU Jinjin(Department of Medical Imaging,People's Hospital of Zhengzhou University(Henan Provincial People's Hospital),Zhengzhou,Henan Province 450003,P.R.China)
出处
《临床放射学杂志》
北大核心
2026年第1期169-175,共7页
Journal of Clinical Radiology
基金
国家自然科学基金项目(编号:82001783)。
关键词
宫颈癌
脉管浸润
虚拟弹性成像
磁共振成像
Cervical cancer
Lymphovascular space invasion
Virtual magnetic resonance elastography
Magnetic resonance imaging
