摘要
目的探讨基于黄金角径向并行采集技术(GRASP)的动态对比增强磁共振成像(DCE-MRI)在评估胃腺癌T分期及病理组织分化程度的应用价值。方法回顾性分析69例胃腺癌患者术前基于GRASP扫描技术的DCE-MRI的影像评估其T分期,并以术后病理T分期为“金标准”,对比分析T分期准确率及T1~T4期的敏感度、特异度。53例进展期胃腺癌患者,按术后病理组织分化程度分为低分化胃腺癌组31例、中/高分化腺癌组22例,分析术前DCE-MRI灌注参数容积转运常数(K^(trans))值、血管外细胞外间隙容积分数(V_(e))、速率常数(K_(ep))及曲面下初始区域值(i-AUC)与胃腺癌组织分化程度的相关性。结果经术后病理证实胃腺癌T1期16例,T2期9例,T3期27例,T4期17例,术前DCE-MRI术前T分期的符合率为85.5%(59/69),其中诊断T1、T2、T3、T4期的敏感度分别为87.50%、77.78%、88.89%、82.35%,特异度分别为86.23%,95.00%、92.86%、96.15%。DCE-MRI灌注参数V_(e)值与组织分化程度具有统计学差异(低分化组V_(e)=0.44±0.14,中/高分化组V_(e)=0.30±0.09,t值=4.621,P<0.001),受试者工作特征(ROC)曲线分析:曲线下面积(AUC)为0.802(95%CI:0.687,0.917,P<0.001),截断值取0.39时,敏感度为62.5%,特异度为87.0%。K^(trans)值、K_(ep)值及i-AUC值与病理分化程度无明显相关性(P>0.05)。结论基于GRASP扫描技术的DCE-MRI评估胃腺癌术前T分期具有较高的准确率,尤其提高T1期的诊断效能;DCE-MRI灌注参数V_(e)值有助于预测术前胃腺癌组织分化程度。
Objective To evaluate the value of dynamic contrast enhanced MRI(DCE-MRI)based on golden angle radial parallel(GRASP)scanning technology in evaluating T stage and pathological differentiation of gastric cancer.Methods The preoperative DCE-MRI images of 69 patients with gastric cancer based on GRASP scanning technique were analyzed retrospectively to evaluate their T staging.With the postoperative pathological T staging as the gold standard,the accuracy of T staging and the sensitivity and specificity of T1-T4 stages were compared and analyzed.Fifty-three patients with advanced gastric adenocarcinoma were divided into poorly differentiated gastric cancer group(n=31)and moderately/well differentiated gastric cancer group(n=22)according to the degree of pathological differentiation after operation.The correlation between preoperative DCE-MRI perfusion parameters K^(trans)value,V_(e)value,K_(ep)value and i-AUC value and the pathological tissue differentiation degree of gastric cancer were analyzed.Results gastric cancer was confirmed by postoperative pathology in 16 cases of T1 stage,9 cases of T2 stage,27 cases of T3 stage and 17 cases of T4 stage.The coincidence rate of preoperative DCE-MRI T staging was 85.5%(59/69).The sensitivity of diagnosis of T1,T2,T3 and T4 was 87.50%,77.78%,88.89%and 82.35%respectively,and the specificity was 86.23%95.00%,92.86%and 96.15%,respectively.There was statistical difference between DCE perfusion parameter V_(e)value and tissue differentiation degree(V_(e)value of low differentiation group:0.44±0.14,V_(e)value of medium/high differentiation group:0.30±0.09,t=4.621,P<0.001),ROC curve analysis:AUC=0.802(95%CI:0.687,0.917,P<0.001).When the cut-off value was 0.39,the sensitivity was 62.5%and the specificity was 87%.There was no significant correlation between K^(trans)value,K_(ep)value and i-AUC value with the degree of pathological differentiation.Conclusion DCE-MRI based on GRASP scan technique can improve the accuracy of preoperative T staging of gastric cancer,especially improve
作者
东强
何珍珍
余玉盛
魏恒乐
张宏
唐桂莹
DONG Qiang;HE Zhenzhen;YU Yusheng(Department of Radiology,Nanjing Jiangning Hospital,Nanjing,Jiangsu Province 211100,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第2期285-290,共6页
Journal of Clinical Radiology
基金
南京医科大学附属江宁医院青年创新科研基金项目(编号:JNYYZXKY202122)。
关键词
胃腺癌
动态对比增强磁共振成像
T分期
组织分化程度
Gastric cancer
Dynamic contrast enhanced MRI
T stage
Pathological tissue differentiation
