磁共振扩散峰度成像在胃癌侵袭性评估中的应用
发布时间：2018-11-04 21:25
【摘要】：目的:探讨磁共振扩散峰度成像(DKI)所得参数与胃癌侵袭性的潜在相关性。材料与方法:该前瞻性研究共纳入了 49例胃癌患者。所有患者在手术之前都接受了磁共振检查。每位患者的磁共振图像都导入工作站软件IDL 6.3进行分析。两名放射科医师在显示肿瘤最大病灶的DKI图像上手动勾画感兴趣区(ROI),由软件自动计算出三个DKI参数:表观扩散系数(ADC)、校正后扩散系数(D)和扩散峰度系数(K)。统计学分析使用SPSS22.0,双侧P值0.05表示有统计学意义。Shapiro-Wilk检验用于分析DKI参数在各个亚组中是否符合正态性分布,Spearman相关性检验用于分析DKI参数与胃癌T分期、N分期、总分期、分化程度及Lauren分型的相关性,不同N分期及Lauren分型的胃癌病灶的DKI参数的差异性应用单因素方差分析,不同T分期(T1-2vsT3-4)、总分期(Ⅰ-Ⅱ vs Ⅲ-Ⅳ)、分化程度(低/中低vs高/中)、淋巴结转移状态(有vs无)、脉管癌栓(有vs无)、神经侵犯(有vs无)的胃癌病灶的DKI参数的差异性应用独立样本t检验分析。受试者工作特征曲线用于分析DKI参数鉴别胃癌不同病理特征的诊断效能。结果:ADC值与胃癌T分期、分化程度及Lauren分型呈显著负相关,K值与胃癌T分期、总分期、分化程度及Lauren分型呈显著正相关,D值均未表现出显著相关性。在胃癌各个病理特征的鉴别诊断上,三个DKI参数各有其优势。ADC、D和K值在T1-2期与T3-4期胃癌的鉴别中有较好的表现(曲线下面积AUC = 0.798、0.745和0.804),ADC和D值有助于鉴别胃癌有无淋巴结转移(AUC=0.741和0.729),ADC和K值有助于鉴别高/中分化与低/中低分化(AUC = 0.732和0.794)、肠型与混合/弥漫型(AUC = 0.678和0.755)的胃癌。而在胃癌有无脉管及神经侵犯的评估上,三个DKI参数均未表现出显著性差异。结论:磁共振扩散峰度成像有助于术前评估胃癌侵袭性,尤其是鉴别胃癌不同T分期、分化程度及Lauren分型,以及预测胃癌患者有无淋巴结转移。
[Abstract]:Objective: to investigate the potential correlation between (DKI) parameters and invasion of gastric cancer. Materials and methods: the prospective study included 49 patients with gastric cancer. All patients underwent magnetic resonance imaging prior to surgery. The MRI images of each patient were imported into the workstation software IDL 6.3 for analysis. Two radiologists manually delineate the region of interest (ROI),) on DKI images showing the largest lesions of the tumor. The software automatically calculates three DKI parameters: apparent diffusion coefficient (ADC),). Corrected diffusion coefficient (D) and diffusion kurtosis coefficient (K). Shapiro-Wilk test was used to analyze the normal distribution of DKI parameters in each subgroup, and Spearman correlation test was used to analyze the relationship between DKI parameters and T stage of gastric cancer. The correlation between N stage, total stage, differentiation degree and Lauren classification, the difference of DKI parameters in different N staging and Lauren classification of gastric cancer was analyzed by univariate ANOVA, different T staging (T1-2vsT3-4). Total stage (鈪，
本文编号：2311180
[Abstract]:Objective: to investigate the potential correlation between (DKI) parameters and invasion of gastric cancer. Materials and methods: the prospective study included 49 patients with gastric cancer. All patients underwent magnetic resonance imaging prior to surgery. The MRI images of each patient were imported into the workstation software IDL 6.3 for analysis. Two radiologists manually delineate the region of interest (ROI),) on DKI images showing the largest lesions of the tumor. The software automatically calculates three DKI parameters: apparent diffusion coefficient (ADC),). Corrected diffusion coefficient (D) and diffusion kurtosis coefficient (K). Shapiro-Wilk test was used to analyze the normal distribution of DKI parameters in each subgroup, and Spearman correlation test was used to analyze the relationship between DKI parameters and T stage of gastric cancer. The correlation between N stage, total stage, differentiation degree and Lauren classification, the difference of DKI parameters in different N staging and Lauren classification of gastric cancer was analyzed by univariate ANOVA, different T staging (T1-2vsT3-4). Total stage (鈪，
本文编号：2311180
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