小视野扩散加权成像ADC值评估肝外胆管癌淋巴血管侵犯的应用价值
Value of reduced field-of-view apparent diffusion coefficient in assessing lymphovascular invasion of extrahepatic cholangiocarcinoma
彭彬 1马培旗 1袁玉山 1张宗夕1
作者信息
- 1. 236000 安徽阜阳,阜阳市人民医院影像中心
- 折叠
摘要
目的 探索基于小视野扩散加权成像(DWI)表观扩散系数(ADC)值对肝外胆管癌淋巴血管侵犯(LVI)的应用价值.方法 回顾性分析经手术病理证实的54例肝外胆管癌的临床及影像学资料,术前均行常规DWI及小视野DWI(r-FOV DWI),两名高年资放射影像诊断医师对常规DWI和小视野DWI图像质量进行5级李克特量表评分,并比较两组图像病灶区信噪比(SNR)、对比信噪比(CNR)和ADC值.根据病理资料分为LVI阳性组和LVI阴性组,分别比较两组间常规和小视野ADC值的差异,以受试者工作特征(ROC)曲线评估常规ADC值和小视野ADC值对LVI的诊断效能.结果 小视野DWI图像质量在主观评分、SNR、CNR比较中均好于常规组,且小视野ADC值小于常规ADC值,差异均有统计学意义(P＜0.05).LVI阳性组中常规组ADC值和小视野ADC值均小于LVI阴性组,差异具有统计学意义(P＜0.05).常规组ADC 值(＜1.217×10-3 mm2/s)诊断 LVI 阳性的曲线下面积(AUC)为 0.746[95％CI(0.609,0.882),P＜0.05],其敏感度及特异度分别为 75.0％、73.5％;小视野组 ADC 值(＜1.092×10-3 mm2/s)诊断 LVI 阳性的 AUC 为 0.932[95％CI(0.866,0.999),P＜0.05],其敏感度及特异度分别为95.0％、85.3％.两组AUC值差异有统计学意义(P＜0.05).结论 小视野DWI成像ADC值较常规ADC值对于预测肝外胆管癌LVI具有更好的诊断价值.
Abstract
Objective To explore the value of apparent diffusion coefficient(ADC)on reduced field-of-view diffusion-weighted magnetic resonance imaging(r-FOV DWI)in assessing lymphovascular invasion(LVI)of extrahepatic cholangiocarcinoma(EHCC).Methods Fifty-four patients with pathologically confirmed EHCC underwent pre-operative conventional and r-FOV DWI.Two senior radiologists evaluated the image quality using a 5-point Likert scale and measured the signal-to-noise ratios(SNR),contrast-to-noise ratios(CNR),and ADC values of the lesions on DWI.According to pathological data,patients were divided into the LVI-positive group and the LVI-negative groups.The conventional and r-FOV ADC values for demonstrating LVI were compared between the two groups using the receiver operating characteristic(ROC)curves.Results The image quality of r-FOV DWI was better with higher scores than that of conventional DWI with significantly higher subjective scores as well as lower SNR,CNR,and ADC values than that of conventional DWI(P＜0.05).Both conventional and r-FOV ADC values in the LVI-positive group were significantly lower than those in the LVI-negative group(P＜0.05).The area under the ROC curve(AUC)for diagnosing LVI using conventional ADC value＜1.217×10-3 mm2/s was 0.746(P＜0.05),with 75.0％sensitivity and 73.5％specificity.The AUC for diagnosing LVI using r-FOV ADC value＜1.092×10-3 mm2/s was 0.932(P＜0.05)with 95.0％sensitivity and 85.3％specificity.The difference in AUC values between the two groups was statistically significant(P＜0.05).Conclusion r-FOV ADC values are better than conventional ADC values for demonstrating LVI of EHCC.
关键词
表观扩散系数/肝外胆管癌/淋巴血管侵犯/扩散加权成像Key words
Apparent diffusion coefficient/Extrahepatic cholangiocarcinoma/Lymphovascular invasion/Diffusion-weighted imaging引用本文复制引用
基金项目
阜阳市自筹经费科技计划(2020)(FK202081049)
出版年
2024
NETL
NSTL
万方数据