扩散峰度成像诊断直肠腺癌:与DWI对比分析
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摘要
目的对比分析扩散峰度成像(DKI)与DWI在直肠腺癌诊断中的应用价值。方法对38例经病理活检证实的直肠腺癌患者(直肠腺癌组)和38名年龄、性别相匹配的健康志愿者(正常对照组)行MR检查(包括常规T1WI、T2WI、DWI、DKI),经图像后处理获得ADC值、平均扩散系数(MD)和平均扩散峰度(MK)。采用Mann-Whitney U秩和检验比较2组各参数的差异,以ROC曲线评价各参数诊断直肠腺癌的效能,采用Spearman秩相关分析ADC值与MD值、MK值的相关性。结果直肠腺癌组MK值高于正常对照组(P<0.001),MD值和ADC值低于正常对照组(P均<0.001)。MK值、MD值、ADC值的ROC曲线AUC分别为0.911、0.888、0.827(P均<0.05);以MK值0.59、MD值2.15×10~(-3 )mm/s~2、ADC值1.35×10~(-3 )mm/s~2为阈值,诊断直肠腺癌的敏感度分别为89.50%、78.90%、76.30%,特异度分别为84.20%、73.70%、73.70%。ADC值与MK值呈负相关(r=-0.460,P<0.05),与MD值呈正相关(r=0.994,P<0.05)。结论 DKI模型和DWI单指数模型均有助于诊断直肠腺癌;DKI可提供关于肿瘤微环境扩散特性的信息,相比DWI单指数模型具有更高诊断效能。
Objective To analyze the application value of diffusion kurtosis imaging(DKI) in diagnosis of rectal adenocarcinoma compared with DWI. Methods Thirty-eight patients of rectal adenocarcinoma confirmed by pathological biopsy(rectal adenocarcinoma group) and 38 healthy volunteers with matched age and gender(normal control group) were collected. MR scanning including T1 WI, T2 WI, DWI and DKI were performed in all subjects. ADC value, mean diffusivity(MD) and mean kurtosis(MK) value were obtained after image processing. Mann-Whitney U was used to compare parameters between the two groups. ROC was used to evaluate the diagnostic efficacy of MK, MD and ADC. Spearman correlation analysis was used to analyze the correlation between ADC and MD, MK. Results MK in rectal adenocarcinoma group was higher than that in normal control group(P<0.001). MD and ADC in rectal adenocarcinoma group were lower than those in normal control group(P<0.001). AUC in diagnosis of rectal adenocarcinoma of MK, MD, ADC was 0.911, 0.888 and 0.827, respectively(all P<0.05). Taken 0.59, 2.15×10~(-3) mm/s~2 and 1.35×10~(-3) mm/s~2 as the thresholds, the sensitivity of MK, MD, ADC was 89.50%, 78.90%, 76.30%, and the specificity was 84.20%, 73.70%, 73.70%, respectively. There was negative correlation between ADC and MK(r=-0.460, P<0.05) and positive correlation between ADC and MD(r=0.994, P<0.05). Conclusion DWI monoexponential parameters and DKI models are helpful to diagnosis of rectal adenocarcinoma. DKI can provide more information about the microenvironment with higher diagnostic efficacy.
Objective To analyze the application value of diffusion kurtosis imaging(DKI) in diagnosis of rectal adenocarcinoma compared with DWI. Methods Thirty-eight patients of rectal adenocarcinoma confirmed by pathological biopsy(rectal adenocarcinoma group) and 38 healthy volunteers with matched age and gender(normal control group) were collected. MR scanning including T1 WI, T2 WI, DWI and DKI were performed in all subjects. ADC value, mean diffusivity(MD) and mean kurtosis(MK) value were obtained after image processing. Mann-Whitney U was used to compare parameters between the two groups. ROC was used to evaluate the diagnostic efficacy of MK, MD and ADC. Spearman correlation analysis was used to analyze the correlation between ADC and MD, MK. Results MK in rectal adenocarcinoma group was higher than that in normal control group(P<0.001). MD and ADC in rectal adenocarcinoma group were lower than those in normal control group(P<0.001). AUC in diagnosis of rectal adenocarcinoma of MK, MD, ADC was 0.911, 0.888 and 0.827, respectively(all P<0.05). Taken 0.59, 2.15×10~(-3) mm/s~2 and 1.35×10~(-3) mm/s~2 as the thresholds, the sensitivity of MK, MD, ADC was 89.50%, 78.90%, 76.30%, and the specificity was 84.20%, 73.70%, 73.70%, respectively. There was negative correlation between ADC and MK(r=-0.460, P<0.05) and positive correlation between ADC and MD(r=0.994, P<0.05). Conclusion DWI monoexponential parameters and DKI models are helpful to diagnosis of rectal adenocarcinoma. DKI can provide more information about the microenvironment with higher diagnostic efficacy.
引文
[1] Siegel R,Desantis C,Jemal A.Colorectal cancer statistics,2014.CA Cancer J Clin,2014,64(2):104-117.
[2] 汪建平.重视结直肠癌流行病学研究.中国实用外科杂志,2013,33(8):622-624.
[3] Hui ES,Cheung MM,Qi L,et al.Towards better MR characterization of neural tissues using directional diffusion kurtosis analysis.Neurimage,2008,42(1):122-134.
[4] Jensen JH,Helpern JA,Ramani A,et al.Diffusion kurtosis imaging:The quantification of non-Gaussian water diffusion by means of magnetic resonance imaging.Magn Reson Med,2005,53(6):1432-1440.
[5] 张顺,姚义好,张水霞,等.脑梗死不同时期的MR扩散峰度成像.中华放射学杂志,2014,48(6):443-447.
[6] 袁理想,孙曼,陈元园,等.早期阿尔茨海默病脑组织非高斯扩散变化的扩散峰度成像研究.中华放射学杂志,2015,49(8):566-571.
[7] Sheng RF,Wang HQ,Yang L,et al.Diffusion kurtosis imaging and diffusion-weighted imaging in assessment of liver fibrosis stage and necroinflammatory activity.Abdom Radiol (NY),2017,42(4):1176-1182.
[8] Raab P,Hattingen E,Franz K,et al.Cerebral gliomas:Diffusional kurtosis imaging analysis of microstructural differences.Radiology,2010,254(3):876-881.
[9] 范光荣,陈翠芬,朱志军,等.磁共振表观扩散系数对非哺乳期乳腺炎和乳腺癌的鉴别诊断价值.临床放射学杂志,2015,34(4):544-547.
[10] 程蓉,窦卫涛.MRI DWI及DCE-MRI综合使用对直肠癌临床分期与诊断价值.医学影像学杂志,2016,26(10):1851-1854.
[11] 孙应实,张晓鹏,唐磊.直肠癌扩散加权成像b值选取及其对直肠癌显示能力的评价.中国医学影像技术,2005,21(12):1839-1841.
[12] Le Bihan D.Molecular diffusion,tissue microdynamics and microstructure.NMR Biomed,1995,8(7-8):375-386.
[13] Poot DHJ,Den Dekker AJ,Achten E,et al.Optimal experimental design for diffusion kurtosis imaging.IEEE Trans Med Imaging,2010,29(3):819-829.
[14] Kamagata K,Tomiyama H,Hatano T,et al.A preliminary diffusional kurtosis imaging study of Parkinson disease:Comparison with conventional diffusion tensor imaging.Neuroradiology,2014,17(4):1-8.
[15] Lu H,Jensen JH,Hu C,et al.Alterations in cerebral microstructural integrity in normal aging and in Alzheimer's disease:A multi-contrast diffusion MRI study.Neuroradiology,2015,32(7):317-322.
[2] 汪建平.重视结直肠癌流行病学研究.中国实用外科杂志,2013,33(8):622-624.
[3] Hui ES,Cheung MM,Qi L,et al.Towards better MR characterization of neural tissues using directional diffusion kurtosis analysis.Neurimage,2008,42(1):122-134.
[4] Jensen JH,Helpern JA,Ramani A,et al.Diffusion kurtosis imaging:The quantification of non-Gaussian water diffusion by means of magnetic resonance imaging.Magn Reson Med,2005,53(6):1432-1440.
[5] 张顺,姚义好,张水霞,等.脑梗死不同时期的MR扩散峰度成像.中华放射学杂志,2014,48(6):443-447.
[6] 袁理想,孙曼,陈元园,等.早期阿尔茨海默病脑组织非高斯扩散变化的扩散峰度成像研究.中华放射学杂志,2015,49(8):566-571.
[7] Sheng RF,Wang HQ,Yang L,et al.Diffusion kurtosis imaging and diffusion-weighted imaging in assessment of liver fibrosis stage and necroinflammatory activity.Abdom Radiol (NY),2017,42(4):1176-1182.
[8] Raab P,Hattingen E,Franz K,et al.Cerebral gliomas:Diffusional kurtosis imaging analysis of microstructural differences.Radiology,2010,254(3):876-881.
[9] 范光荣,陈翠芬,朱志军,等.磁共振表观扩散系数对非哺乳期乳腺炎和乳腺癌的鉴别诊断价值.临床放射学杂志,2015,34(4):544-547.
[10] 程蓉,窦卫涛.MRI DWI及DCE-MRI综合使用对直肠癌临床分期与诊断价值.医学影像学杂志,2016,26(10):1851-1854.
[11] 孙应实,张晓鹏,唐磊.直肠癌扩散加权成像b值选取及其对直肠癌显示能力的评价.中国医学影像技术,2005,21(12):1839-1841.
[12] Le Bihan D.Molecular diffusion,tissue microdynamics and microstructure.NMR Biomed,1995,8(7-8):375-386.
[13] Poot DHJ,Den Dekker AJ,Achten E,et al.Optimal experimental design for diffusion kurtosis imaging.IEEE Trans Med Imaging,2010,29(3):819-829.
[14] Kamagata K,Tomiyama H,Hatano T,et al.A preliminary diffusional kurtosis imaging study of Parkinson disease:Comparison with conventional diffusion tensor imaging.Neuroradiology,2014,17(4):1-8.
[15] Lu H,Jensen JH,Hu C,et al.Alterations in cerebral microstructural integrity in normal aging and in Alzheimer's disease:A multi-contrast diffusion MRI study.Neuroradiology,2015,32(7):317-322.