动态增强磁共振成像在肺癌脊柱转移判别诊断中的应用

发布时间：2018-06-23 00:19

本文选题：肺肿瘤 + 肿瘤转移　；参考：《中国医学影像学杂志》2017年09期

【摘要】：目的探讨动态增强磁共振成像(DCE-MRI)在肺癌脊柱转移判别诊断中的应用价值。资料与方法对61例脊柱转移癌患者行DCE-MRI,对扫描获得的图像进行后处理,获得信号强度-时间曲线、曲线上升期信号强度增幅(Peak SE%)、曲线最大上升线性斜率(Max Wash-in SE%)、曲线下降斜率(Wash-out SE%)等半定量参数,应用双室药物代谢动力学分析获得容积转运常数(K~(trans))和速率常数(K_(ep))等定量参数。应用CHAID法建立决策树模型,确定最佳分类参数,并识别最优分割。结果 61例脊柱转移癌患者的DCE-MRI扫描参数中Wash-out SE%、K_(ep)在肺癌与其他肿瘤脊柱转移之间差异有统计学意义(P0.01),而Peak SE%、Max Wash-in SE%、K~(trans)在两者之间差异无统计学意义(P0.05);当Wash-out SE%-660.6%且Max Wash-in SE%98.0%时约94.7%的患者原发灶可能来源于肺;使用本研究建立的决策树进行判别时,10-折交叉验证显示其错误率为(29.5±5.8)%。结论采用DCE-MRI半定量及定量分析参数进行肺癌脊柱转移的判别诊断具有可行性,可以为脊柱转移癌的来源鉴别及临床治疗提供参考依据。
[Abstract]:Objective to evaluate the value of dynamic enhanced magnetic resonance imaging (DCE-MRI) in the differential diagnosis of spinal metastasis of lung cancer. Materials and methods DCE-MRI was performed in 61 patients with spinal metastatic carcinoma. The semi-quantitative parameters such as peak signal intensity increase (Peak SE%), Max Wash-in SE%, Wash-SE% and Wash-SE% were obtained by two-compartment pharmacokinetic analysis. The volume transport constants (K ~ (trans) and rate constants (K _ (ep) were obtained by two-compartment pharmacokinetic analysis. The decision tree model is established by Chaid method, the optimal classification parameters are determined and the optimal segmentation is identified. Results among the DCE-MRI parameters of 61 patients with spinal metastatic carcinoma, there was a significant difference in Wash-out set K- (ep) between lung cancer and other tumors (P0.01), but there was no significant difference in peak SEand Wash-in Max SEK ~ (trans) between the two groups (P0.05); when Washout SEI was -660.6% and Max Wash-in SE was used, there was no significant difference between them (P0.05). About 94.7% of the patients' primary lesions may originate from the lung. The error rate of decision tree was (29.5 卤5.8). Conclusion it is feasible to use DCE-MRI to diagnose the spinal metastasis of lung cancer by using the semi-quantitative and quantitative analysis parameters, which can provide reference for the source differentiation and clinical treatment of spinal metastases.
【作者单位】：北京大学第三医院放射科;加州大学Tu&Yun肿瘤功能成像中心;北京大学国际医院放射科;
【基金】：北京市自然科学基金(7164309) 国家自然科学基金(81701648)
【分类号】：R445.2;R734.2

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