摘要
目的探讨肺癌MRI动态增强模式和肿瘤微血管密度与肺癌淋巴结转移的关系及其价值。方法将58例原发性肺癌根据病理报告分为有淋巴结转移组和无淋巴结转移组,对所有病例行动态增强MR扫描,根据时间-信号强度曲线计算肺癌动态增强MRI参数,并对癌肿作微血管密度计数(MVD),分析上述数据与肺癌淋巴结转移的关系。结果肺癌淋巴结转移组(35例)的MVD及曲线最大增强线性斜率(SS)均高于无淋巴结转移组(23例)[MVD分别为(72.37±13.74)条/0.74mm2、(42.61±16.18)条/0.74mm2;SS分别为(5.05±1.16)%/s、(2.57±1.09)%/s](t值分别为7.521、8.157,P值均<0.01)。利用ROC曲线分析,当以SS值>3.8%/s或MVD值>63条/0.74mm2作为强烈提示有淋巴结转移的可能性时,参数SS较MVD具有更高的敏感度[分别为85.7%(30/35)、74.3%(26/35)]和诊断符合率[分别为87.9%(51/58)、82.8%(48/58)]。2条ROC曲线下的面积AZSS、AZMVD分别为0.958、0.920,AZSS>AZMVD,但两者间的差异无统计学意义(P=0.09)。结论参数MVD与SS均与肺癌淋巴结转移存在密切的关系,可作为术前判断肺癌淋巴结转移的预测因子和判断预后指标,而且快速、无创的动态增强MRI方法较病理组织学方法更具有优越性。
Objective To investigate the correlations of lymphatic involvement and perfusion patterns of pulmonary carcinoma derived by dynamic contrast-enhanced MRI as well as the histological microvessel density （ MVD ） of the tumors. Methods Fifty-eight patients with pulmonary carcinoma were classified into two group according to the pathologic reports：tumors with mediastinum lymphatic involvement and tumors without mediastinum lymphatic involvement. All cases were underwent dynamic contrastenhanced MR scanning. The parameters of dynamic contrast-enhanced MRI were calculated based on timesignal intensity curves. The correlations of lymphatic involvement and MRI parameters as well as tumors MVD were analyzed. Results Tumors with mediastinum lymphatic involvement （n = 35 ） had significantly higher values of both MVD and SS than those without mediastinum lymphatic involvement （ n = 23 ） （ MVD = 72.37 ±13.74 vs 42. 61 ± 16. 18;SS =5.05 ± 1.16 vs 2. 57 ± 1.09） （t =7. 521;t =8. 157,P 〈0.01）. With the ROC curve analysis, if the SS 3.8 or MVD 63 was taken as s a threshold to predict lymphatic involvement, high sensitivity of SS （ 85.7% , 30 of 35 ）, MVD （ 74. 3 %, 26 of 35 ） and high overall accuracy of SS （87.9,51 of 58）, MVD （82. 8% , 48 of 58） could be reached, respectively. The area zone under the ROC curve of SS （AZss） tended to have higher value than that of MVD （AZMvD） （0. 958 versus 0. 920） , however, the difference between the values of AZss and AZMvo was not significant （P =0. 09 ） . Conclusion SS and MVD had good correlation with lymphatic involvement of pulmonary carcinoma, and could be used to predict lymphatic involvement.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2006年第2期176-180,共5页
Chinese Journal of Radiology
基金
国家自然科学基金资助项目(30170284)
关键词
磁共振成像
肺肿瘤
淋巴转移
新生血管化
病理性
ROC曲线
Magnetic resonance imaging
Lung neoplasms
Lymphatic metastasis
Neovascularization,pathologic
ROC curve
