摘要
目的 探讨小视野体素内不相干运动扩散成像(ZOOMit IVIM-DWI)与扩散峰度成像(DKI)的定量参数在区分肺癌不同病理类型中的应用价值.方法 选取在山东省立医院经病理证实的 95 例肺癌患者为观察对象,按照细胞类型将其分为小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC)两组,NSCLC组 79 例,包括腺癌 57 例,鳞癌 22 例,SCLC组 16例.纳入的患者术前均具有完整的影像学资料,经手术或穿刺活检获取病理结果.术前行ZOOMit IVIM-DWI及DKI序列扫描,人工勾画感兴趣区,比较肺癌不同病理类型的真实扩散系数(D值)、假扩散系数(D*值)、灌注分数(f值)、平均扩散峰度(MK值)、平均扩散系数(MD值)差异,采用受试者工作特征曲线(ROC)评价各参数的诊断效能.结果 NSCLC的D值、f值、MD值大于SCLC,MK值小于SCLC,差异均有统计学意义(P<0.05),各参数鉴别诊断效能曲线下面积大于0.700(P<0.05),其中IVIM-DWI的D值、DKI的MD值分别为 0.903、0.912(P<0.001);而腺癌与鳞癌之间各参数值的差异无统计学意义(P>0.05).IVIM-DWI的D*值在肺癌常见病理类型的鉴别中,差异无统计学意义(P>0.05).结论 ZOOMit IVIM-DWI与DKI在鉴别肺癌病理类型中有一定应用价值,其中DKI的MD值与ZOOMit IVIM-DWI的D值诊断效能高于其它定量参数,并且DKI的MD值的诊断特异性最高.
Abstract
Objective To explore the value of quantitative parameters of small field of view intravoxel incoherent motion dif-fusion imaging(ZOOMit IVIM-DWI)and diffusion kurtosis imaging(DKI)in differentiating different pathological types of lung cancer.Methods Ninety-five cases of lung cancer hospitalized and pathologically confirmed in Shandong Provincial Hospital were collected as study subjects.According to cell type,the 95 cases of lung cancer were divided into two groups,i.e.,small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).In detail,there were 79 cases of NSCLC,including 57 adenocar-cinomas,22 squamous carcinomas,and 16 cases of SCLC.The patients included in the study had completed preoperative imag-ing,and their pathologic results were obtained by surgery or puncture biopsy.ZOOMit IVIM-DWI and DKI sequential scans were performed before surgery,and the regions of interest were manually outlined as required to compare the differences in true diffu-sion coefficients(D-values),pseudo-diffusion coefficients(D*-values),perfusion fractions(f-values),mean kurtosis of diffu-sion(MK-values),and mean diffusion coefficients(MD-values)among different pathologic subtypes of lung cancers.The diag-nostic efficacy of the parameters was evaluated using a subject's work characteristic curve(ROC).Results The D,f,and MD values of NSCLC were greater than those of SCLC,and the MK values were smaller than those of SCLC,and the differences were statistically significant(P<0.05),and the areas under the differential diagnostic efficacy curves of each parameter were greater than 0.7(P<0.05),in which the D value of IVIM-DWI and the MD value of DKI were 0.903 and 0.912,respectively(P<0.001);and the differences of each parameter value between adenocarcinoma and squamous cancer were not statistically signifi-cant(P>0.05).The differences in the values of each parameter between adenocarcinoma and squamous carcinoma were not sta-tistically significant(P>0.05).None of the differences in D* values of IVIM-DWI in the differentiation of common pathologic types of lung cancer were statistically significant(P>0.05).Conclusion ZOOMit IVIM-DWI and DKI have some value in identifying the pathologic types of lung cancer,in which the diagnostic efficacy of the MD value of DKI and the D value of ZOOMit IVIM-DWI is higher than that of the other quantitative parameters,and the diagnostic specificity of the MD value of DKI is the highest.
NETL
NSTL
维普
万方数据