摘要
目的探讨体素内不相干运动(IVIM)成像在食管鳞癌神经侵犯术前评估中的应用价值。方法采用前瞻性研究方法。选取2016年1月至2019年4月郑州大学附属肿瘤医院(河南省肿瘤医院)收治的63例术前行IVIM成像检查食管鳞癌患者的临床病理资料。患者均于术前行常规磁共振成像扫描及IVIM成像序列检查,计算表观扩散系数、扩散系数、灌注系数及灌注分数值。观察指标:(1)入组患者情况。(2)食管鳞癌神经侵犯IVIM成像检查情况及其诊断效能。正态分布的计量资料以x±s表示,组间比较采用独立样本t检验;偏态分布的计量资料以M(Q1,Q3)或M(范围)表示,组间比较采用Wilcoxon秩和检验。计数资料以绝对数表示,组间比较采用χ^(2)检验。采用组内相关系数(ICC)评价结果的一致性,采用受试者工作特征曲线下面积(AUC)评价诊断效能。结果(1)入组患者情况:筛选出符合条件的患者63例;男41例,女22例;年龄为60(43~74)岁。63例食管鳞癌患者中,神经侵犯17例,无神经侵犯46例。神经侵犯和无神经侵犯患者肿瘤分化程度(高分化、中分化、低分化),浸润深度(T1期、T2期、T3期、T4期),淋巴结转移(有、无)分别为0、6、11例,0、3、13、1例,15、2例和6、24、16例,1、22、23、0例,12、34例,两者上述指标比较,差异均有统计学意义(Z=-2.32、-2.49,χ^(2)=19.58,P<0.05)。(2)食管鳞癌神经侵犯IVIM成像检查情况及其诊断效能:神经侵犯和无神经侵犯患者表观扩散系数值、扩散系数值、灌注系数值、灌注分数值分别为(2.21±0.33)×10^(‒3) mm^(2)/s、(1.46±0.31)×10^(‒3) mm^(2)/s、32.50(15.55,46.75)×10^(‒3) mm^(2)/s、(0.34±0.09)×10^(‒3) mm^(2)/s和(2.45±0.45)×10^(‒3) mm^(2)/s、(1.72±0.38)×10^(‒3) mm^(2)/s、34.85(23.43,51.20)×10^(‒3) mm^(2)/s、(0.42±0.13)×10^(‒3) mm^(2)/s,两者表观扩散系数值、扩散系数值、灌注分数值比较,差异均有统计学意义(t=-2.03,-2.52,-2.34,
Objective To investigate the application value of intravoxel incoherent motion(IVIM)imaging in preoperative evaluating perineural invasion(PNI)of esophageal squamous cell carcinoma(ESCC).Methods The prospective study was conducted.The clinicopathological data of 63 ESCC patients who underwent IVIM imaging before surgery in the Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital from January 2016 to April 2019 were selected.Patients underwent routine magnetic resonance imaging scan and IVIM sequence examination.The apparent diffusion coefficient(ADC),true diffusion coefficient(D),pseudodiffusion coefficient(D*)and pseudodiffusion fraction(f)values were measured.Observation indicators:(1)situations of enrolled patients;(2)IVIM examination of PNI of ESCC and its diagnostic efficiency.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using the independent sample t test.Measurement data with skewed distribution were represented as M(Q1,Q3)or M(range),and comparison between groups was analyzed using the Wilcoxon rank sum test.Count data were described as absolute numbers,and comparison between groups was analyzed using the chi-square test.The interclass correlation coefficient(ICC)was used to evaluate cosistency of results.The receiver operating characrteristic curve was used to evaluate diagnostic efficiency.Results(1)Situations of enrolled patients.A total of 63 patients were selected for eligibility.There were 41 males and 22 females,aged 60(range,43‒74)years.Of the 63 ESCC patients,17 cases had PNI and 46 cases had no PNI.Cases with well differentiated tumor,moderate differentiated tumor or low differentiated tumor,cases in stage T1,T2,T3,T4 of infiltra-tion depth,cases with or without lymph node metastasis were 0,6,11,0,3,13,1,15,2 in patients with PNI,versus 6,24,16,1,22,23,0,12,34 in patients without PNI,showing significant differences between them(Z=‒2.32,‒2.49,χ^(2)=19.58,P<0.05).(2)IVIM examination of PNI of ESCC and i
作者
宋涛
路双
张宏凯
冯稳
黎海亮
巴玉峰
曲金荣
Song Tao;Lu Shuang;Zhang Hongkai;Feng Wen;Li Hailiang;Ba Yufeng;Qu Jinrong(Department of Radiology,Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou 450008,China;Department of Pathology,Affiliated Cancer Hospital of Zhengzhou Univer-sity&Henan Cancer Hospital,Zhengzhou 450008,China;Department of Thoracic Surgery,Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou 450008,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2022年第8期1104-1111,共8页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金(81972802)
河南省卫生健康科技创新领军人才培养项目(YXKC 2020011)
河南省重点研发与推广专项(212102310133)
河南省医学科技攻关计划省部共建重点项目(SBGJ202002021)。
关键词
食管肿瘤
磁共振成像
体素内不相干运动
扩散加权成像
神经侵犯
Esophageal neoplasms
Magnetic resonance imaging
Intravoxel incoherent motion
Diffusion-weighted imaging
Perineural invasion
