摘要
目的探索基于小视野扩散加权成像(DWI)表观扩散系数(ADC)值对肝外胆管癌淋巴血管侵犯(LVI)的应用价值。方法回顾性分析经手术病理证实的54例肝外胆管癌的临床及影像学资料,术前均行常规DWI及小视野DWI(r-FOV DWI),两名高年资放射影像诊断医师对常规DWI和小视野DWI图像质量进行5级李克特量表评分,并比较两组图像病灶区信噪比(SNR)、对比信噪比(CNR)和ADC值。根据病理资料分为LVI阳性组和LVI阴性组,分别比较两组间常规和小视野ADC值的差异,以受试者工作特征(ROC)曲线评估常规ADC值和小视野ADC值对LVI的诊断效能。结果小视野DWI图像质量在主观评分、SNR、CNR比较中均好于常规组,且小视野ADC值小于常规ADC值,差异均有统计学意义(P<0.05)。LVI阳性组中常规组ADC值和小视野ADC值均小于LVI阴性组,差异具有统计学意义(P<0.05)。常规组ADC值(<1.217×10^(-3)mm^(2)/s)诊断LVI阳性的曲线下面积(AUC)为0.746[95%CI(0.609,0.882),P<0.05],其敏感度及特异度分别为75.0%、73.5%;小视野组ADC值(<1.092×10^(-3)mm^(2)/s)诊断LVI阳性的AUC为0.932[95%CI(0.866,0.999),P<0.05],其敏感度及特异度分别为95.0%、85.3%。两组AUC值差异有统计学意义(P<0.05)。结论小视野DWI成像ADC值较常规ADC值对于预测肝外胆管癌LVI具有更好的诊断价值。
Objective To explore the value of apparent diffusion coefficient(ADC)on reduced field-of-view diffusion-weighted magnetic resonance imaging(r-FOV DWI)in assessing lymphovascular invasion(LVI)of extrahepatic cholangiocarcinoma(EHCC).Methods Fifty-four patients with pathologically confirmed EHCC underwent pre-operative conventional and r-FOV DWI.Two senior radiologists evaluated the image quality using a 5-point Likert scale and measured the signal-to-noise ratios(SNR),contrast-to-noise ratios(CNR),and ADC values of the lesions on DWI.According to pathological data,patients were divided into the LVI-positive group and the LVI-negative groups.The conventional and r-FOV ADC values for demonstrating LVI were compared between the two groups using the receiver operating characteristic(ROC)curves.Results The image quality of r-FOV DWI was better with higher scores than that of conventional DWI with significantly higher subjective scores as well as lower SNR,CNR,and ADC values than that of conventional DWI(P<0.05).Both conventional and r-FOV ADC values in the LVI-positive group were significantly lower than those in the LVI-negative group(P<0.05).The area under the ROC curve(AUC)for diagnosing LVI using conventional ADC value<1.217×10^(-3)mm^(2)/s was 0.746(P<0.05),with 75.0%sensitivity and 73.5%specificity.The AUC for diagnosing LVI using r-FOV ADC value<1.092×10^(-3)mm^(2)/s was 0.932(P<0.05)with 95.0%sensitivity and 85.3%specificity.The difference in AUC values between the two groups was statistically significant(P<0.05).Conclusion r-FOV ADC values are better than conventional ADC values for demonstrating LVI of EHCC.
作者
彭彬
马培旗
袁玉山
张宗夕
PENG Bin;MA Peiqi;YUAN Yushan;ZHANG Zongxi(Medical Imaging Center,Fuyang People’s Hospital,Anhui 236000,China)
出处
《影像诊断与介入放射学》
2024年第2期83-88,共6页
Diagnostic Imaging & Interventional Radiology
基金
2020阜阳市自筹经费科技计划项目(FK202081049)。
关键词
表观扩散系数
肝外胆管癌
淋巴血管侵犯
扩散加权成像
Apparent diffusion coefficient
Extrahepatic cholangiocarcinoma
Lymphovascular invasion
Diffusion-weighted imaging
