摘要
目的传统磁共振扩散加权成像(diffusion-weighted imaging,DWI)单指数模型和双指数模型不能客观并真实反映组织扩散的生物学特征。本研究探讨体素不相干运动扩散加权成像(intravoxel incoherent motion diffusion weighted imaging,IVIM-DWI)拉伸指数模型参数对食管癌的诊断价值。方法选取山东省肿瘤医院2018-01-01-2019-06-30入院治疗的15例经病理确诊未经化放疗食管癌患者作为病例组,选择同院同期15例行胸部MRI检查的食管正常患者作为对照组,均行IVIM-DWI扫描,分别测量食管癌组织和正常食管内膜组织拉伸指数模型参数值,包括分布扩散系数(distributed diffusion coefficient,DDC)和扩散异质性指数(diffusion heterogeneity index,α)。将病理结果作为金标准,采用受试者工作特征曲线(receiver operator characteristic curve,ROC曲线)评价参数DDC、α和DDC联合α的诊断效能。结果各参数曲线下面积(area under the curve,AUC)均>0.5,其中DDC联合α的ROC AUC最大为0.99,联合试验可提高诊断效能。根据约登指数最大点对应值为诊断的阈值,DDC为0.8×10-3mm2/s,α为0.53。2个参数并联试验,灵敏度、特异度及Kappa值均大于单项试验,其灵敏度达到100%,Kappa=0.847,表明与病理诊断具有非常好的一致性。结论IVIM-DWI拉伸指数模型能够有效区分食管癌组织与正常食管组织,拉伸指数模型参数DDC和α联合诊断效能优于单独的诊断效能,具有较高的临床应用价值。
OBJECTIVE Traditional diffusion-weighted imaging(DWI)single-index model and double-index model cannot reflect the biological characteristics of tissue diffusion objectively and truly.To explore the significance of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)tensile exponential model parameters analysis in the diagnosis of esophageal cancer.METHODS From January 1,2018 to June 30,2019,15 pathologically confirmed esophageal cancer patients without chemotherapy in Shandong Cancer Hospital were selected as the case group and 15 normal esophageal patients who underwent chest MRI examination at the same time in the same hospital were selected as the control group.All patients underwent IVIM-DWI scanning.The model parameter values of tensile index(including DDC andα)of esophageal carcinoma and normal esophageal endometrial tissue were measured respectively,and the pathological results were taken as the"gold standard".The receiver operator characteristic(ROC)curve was used to evaluate the diagnostic efficacy of parameters DDC,αand DDC combined withα,and the paired test was conducted for the three groups of parameters.RESULTS The AUC of each parameter were all>0.5,and the maximum AUC of DDC combinedαwas 0.99.The combined test could improve the diagnostic efficacy.According to the value corresponding to the maximum point of the jorden index as the diagnostic threshold,the DDC was 0.8×10-3 mm2/s.αwas 0.53.The sensitivity,specificity and Kappavalue of the two parameters in parallel test were all greater than that of the single test,and the sensitivity reached 100%,Kappa=0.847,indicating a very good consistency with the pathological diagnosis.CONCLUSION IVIM-DWI tensile exponential model parameters was able to differentiated esophageal cancer from normal esophageal tissue,and tensile exponential model parameters DDC andαcombined was superior than each independent parameter in the diagnosis of esophageal cancer,and it has higher clinical application value.
作者
张明
赵其煜
王庆宜
李万湖
ZHANG Ming;ZHAO Qi-yu;WANG Qing-yi;LI Wan-hu(School of Medicine and Life Sciences,University of Jinan-shandong Academy of Medical Sciences,Jinan250022,P.R.China;Maternal and Child Health Hospital of Liaocheng Dongchangfu District,Liaocheng252000,P.R.China;Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy ofMedical Sciences,Jinan250117,P.R.China)
出处
《社区医学杂志》
2020年第7期490-493,共4页
Journal Of Community Medicine
关键词
体素内不相干运动
拉伸指数模型
食管癌
磁共振成像
扩散加权成像
intravoxel incoherent motion
tensile exponential model
esophageal cancer
magnetic resonance imaging
diffusion weighted imaging
作者简介
第一作者:张明,女,山东茌平人,住院医师,主要从事影像诊断的临床研究工作。E-mail:441691141@qq.com;通信作者:李万湖,男,山东茌平人,硕士,副主任医师,主要从事肿瘤影像诊断的临床研究工作。Tel:86-531-67626209,E-mail:lwhvzg@126.com
