目的探讨并比较单指数模型、双指数模型、拉伸指数模型定量参数对乳腺癌HER2阳性状态的预测价值。方法回顾性分析67例确诊为浸润性乳腺癌患者的影像及临床资料。在病灶表观扩散系数(ADC)图像勾画感兴趣区(ROI),并对照扩散加权成像(DWI)...目的探讨并比较单指数模型、双指数模型、拉伸指数模型定量参数对乳腺癌HER2阳性状态的预测价值。方法回顾性分析67例确诊为浸润性乳腺癌患者的影像及临床资料。在病灶表观扩散系数(ADC)图像勾画感兴趣区(ROI),并对照扩散加权成像(DWI)图像修正ROI,记录病灶的表观扩散系数(ADC)、伪扩散系数(ADC_(fast))、真实扩散系数(ADC_(slow))、灌注分数(ADC_(fraction of fast))、分布扩散系数(DDC)、扩散异质性值(α)。根据免疫组化结果,将患者分为两组(HER2阳性vs.HER2阴性)。采用单因素分析比较两组间三种指数模型的六项定量参数(ADC、ADC_(fast)、ADC_(slow)、ADC_(fraction of fast)、DDC、α)组间差异。将具有统计学差异的定量参数纳入二元Logistic回归分析,并构建联合预测模型。采用DeLong检验比较三种模型定量参数、联合模型的受试者工作特征(ROC)曲线下面积(AUC),区分诊断效能。结果HER2阳性组ADC_(fast)值高于HER2阴性组(P<0.05),ADC、ADC_(slow)、DDC值低于HER2阴性组(均P<0.05)。ADC、ADC_(fast)、ADC_(slow)、DDC、ADC_(fast)-ADC_(slow)联合模型的AUC分别为75.85%、71.11%、76.92%、71.11%、88.19%;ADC_(fast)-ADC_(slow)联合模型的AUC最高,诊断效能显著优于ADC_(fast)(P=0.009),与ADC、ADC_(slow)、DDC相仿(均P>0.05);ADC、ADC_(fast)、ADC_(slow)、DDC的诊断效能组间比较表现相仿(均P>0.05)。结论三种不同指数模型定量参数有助于预测乳腺癌HER2阳性状态;双指数模型参数联合模型预测效能最优。展开更多
Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 3...Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.展开更多
目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月...目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月—2021年12月在首都医科大学电力教学医院就诊的101例临床怀疑为前列腺癌患者的临床、影像学及病理学资料。依据穿刺活检结果分为组1(临床显著性前列腺癌组)和组2(非临床显著性前列腺癌+非前列腺癌),由2名阅片者依据前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)指南评分标准分别按照bpMRI诊断方案和多参数MRI(multi-parametric MRI,mpMRI)诊断方案进行评分(记为bpMRI评分和mpMRI评分),并且测量病灶最大层面的ADC值和eADC值,将bpMRI评分和mpMRI评分分别与ADC值及eADC值联合构建logistic回归模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价ADC值、eADC值、bpMRI诊断方案、mpMRI诊断方案以及两者分别联合ADC值及eADC值对临床显著性前列腺癌的诊断价值,运用Z检验对比各方案的曲线下面积(area under curve,AUC)有无差异。结果:109例可疑病灶中,组1病灶共计50例,组2病灶共计59例。ADC值、eADC值、bpMRI评分及mpMRI评分是诊断临床显著性前列腺癌的有效指标(P<0.001),ADC值及eADC值的AUC值分别为0.888和0.931,差异无统计学意义(Z=1.512,P=0.1306)。BpMRI评分分别联合ADC值及eADC值的AUC值分别为0.973、0.978,高于单独运用bpMRI评分的AUC值(AUC=0.954),差异有统计学意义(Z=2.391,P=0.0168;Z=2.125,P=0.0336)。mpMRI评分分别联合ADC值及eADC值的AUC值分别为0.985、0.985,高于单独运用mpMRI评分的AUC值(AUC=0.974),但差异无统计学意义(Z=1.295,P=0.1953;Z=1.354,P=0.1757)。结论:ADC值和eADC值都是诊断临床显著性前列腺癌有价值的MRI定量指标,两者联合bpMRI评分可以显著地提高bpMRI的诊断效能与临床应用价值。展开更多
文摘目的探讨并比较单指数模型、双指数模型、拉伸指数模型定量参数对乳腺癌HER2阳性状态的预测价值。方法回顾性分析67例确诊为浸润性乳腺癌患者的影像及临床资料。在病灶表观扩散系数(ADC)图像勾画感兴趣区(ROI),并对照扩散加权成像(DWI)图像修正ROI,记录病灶的表观扩散系数(ADC)、伪扩散系数(ADC_(fast))、真实扩散系数(ADC_(slow))、灌注分数(ADC_(fraction of fast))、分布扩散系数(DDC)、扩散异质性值(α)。根据免疫组化结果,将患者分为两组(HER2阳性vs.HER2阴性)。采用单因素分析比较两组间三种指数模型的六项定量参数(ADC、ADC_(fast)、ADC_(slow)、ADC_(fraction of fast)、DDC、α)组间差异。将具有统计学差异的定量参数纳入二元Logistic回归分析,并构建联合预测模型。采用DeLong检验比较三种模型定量参数、联合模型的受试者工作特征(ROC)曲线下面积(AUC),区分诊断效能。结果HER2阳性组ADC_(fast)值高于HER2阴性组(P<0.05),ADC、ADC_(slow)、DDC值低于HER2阴性组(均P<0.05)。ADC、ADC_(fast)、ADC_(slow)、DDC、ADC_(fast)-ADC_(slow)联合模型的AUC分别为75.85%、71.11%、76.92%、71.11%、88.19%;ADC_(fast)-ADC_(slow)联合模型的AUC最高,诊断效能显著优于ADC_(fast)(P=0.009),与ADC、ADC_(slow)、DDC相仿(均P>0.05);ADC、ADC_(fast)、ADC_(slow)、DDC的诊断效能组间比较表现相仿(均P>0.05)。结论三种不同指数模型定量参数有助于预测乳腺癌HER2阳性状态;双指数模型参数联合模型预测效能最优。
文摘Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.
文摘目的:探究表观弥散系数(apparent diffusion coefficient,ADC)及指数化ADC(exponential ADC,eADC)在双参数磁共振成像(bi-parametric magnetic resonance imaging,bpMRI)诊断临床显著性前列腺癌中的应用价值。方法:回顾并分析2014年1月—2021年12月在首都医科大学电力教学医院就诊的101例临床怀疑为前列腺癌患者的临床、影像学及病理学资料。依据穿刺活检结果分为组1(临床显著性前列腺癌组)和组2(非临床显著性前列腺癌+非前列腺癌),由2名阅片者依据前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)指南评分标准分别按照bpMRI诊断方案和多参数MRI(multi-parametric MRI,mpMRI)诊断方案进行评分(记为bpMRI评分和mpMRI评分),并且测量病灶最大层面的ADC值和eADC值,将bpMRI评分和mpMRI评分分别与ADC值及eADC值联合构建logistic回归模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价ADC值、eADC值、bpMRI诊断方案、mpMRI诊断方案以及两者分别联合ADC值及eADC值对临床显著性前列腺癌的诊断价值,运用Z检验对比各方案的曲线下面积(area under curve,AUC)有无差异。结果:109例可疑病灶中,组1病灶共计50例,组2病灶共计59例。ADC值、eADC值、bpMRI评分及mpMRI评分是诊断临床显著性前列腺癌的有效指标(P<0.001),ADC值及eADC值的AUC值分别为0.888和0.931,差异无统计学意义(Z=1.512,P=0.1306)。BpMRI评分分别联合ADC值及eADC值的AUC值分别为0.973、0.978,高于单独运用bpMRI评分的AUC值(AUC=0.954),差异有统计学意义(Z=2.391,P=0.0168;Z=2.125,P=0.0336)。mpMRI评分分别联合ADC值及eADC值的AUC值分别为0.985、0.985,高于单独运用mpMRI评分的AUC值(AUC=0.974),但差异无统计学意义(Z=1.295,P=0.1953;Z=1.354,P=0.1757)。结论:ADC值和eADC值都是诊断临床显著性前列腺癌有价值的MRI定量指标,两者联合bpMRI评分可以显著地提高bpMRI的诊断效能与临床应用价值。
