| 王华梦,舒健,黄新荞,周铁军,苏松.表观弥散系数值用于预测肝外胆管癌淋巴血管侵犯[J].中国介入影像与治疗学,2022,19(1):31-35 |
| 表观弥散系数值用于预测肝外胆管癌淋巴血管侵犯 |
| Apparent diffusion coefficient for predicting lymphovascular invasion from extrahepatic cholangiocarcinoma |
| 投稿时间：2021-07-19 修订日期：2021-09-02 |
| DOI：10.13929/j.issn.1672-8475.2022.01.007 |
| 中文关键词: 胆管肿瘤 肿瘤转移 淋巴转移 弥散加权成像 |
| 英文关键词:bile duct neoplasms neoplasm metastasis lymphatic metastasis diffusion weighted imaging |
| 基金项目:四川省卫生健康委员会科研课题资助项目（19PJ151）。 |
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| 中文摘要: |
| 目的 分析表观弥散系数（ADC）用于评估肝外胆管癌（ECCA）淋巴血管侵犯（LVI）的价值。方法 回顾性分析经术后病理证实的85例单发ECCA患者，术前均接受常规MRI及弥散加权成像（DWI），根据病理结果将其分为LVI阳性组与LVI阴性组；比较组间ADC值差异，以受试者工作特征（ROC）曲线评估ADC值对LVI的诊断效能。结果 85例ECCA中，22例存在LVI（LVI阳性组），63例无LVI（LVI阴性组）。LVI阳性组ADC值为1.17×10-3（1.08×10-3，1.31×10-3）mm2/s，LVI阴性组为1.32×10-3（1.25×10-3，1.45×10-3）mm2/s，组间差异有统计学意义（P<0.05）。ADC值诊断LVI阳性的ROC曲线下面积（AUC）为0.80[95%CI（0.69，0.91），P<0.05]，判断LVI阳性的ADC值阈值为1.18×10-3 mm2/s，其诊断敏感度、特异度、阳性预测值、阴性预测值及准确率分别为63.64%（14/22）、90.48%（57/63）、70.00%（14/20）、87.69%（57/65）及83.53%（71/85）。结论 基于ADC值可判断ECCA患者是否存在LVI。 |
| 英文摘要: |
| Objective To explore the value of apparent diffusion coefficient (ADC) for assessment of lymphovascular invasion (LVI) from extrahepatic cholangiocarcinoma (ECCA). Methods Totally 85 patients with single ECCA lesion confirmed by postoperative pathology were retrospectively analyzed. All patients underwent conventional MRI and diffusion weighted imaging (DWI) before operation. The patients were divided into LVI positive group and LVI negative group according to pathological results. ADC values were compared between groups, and the diagnostic efficacy of ADC values for LVI was evaluated with receiver operating characteristic (ROC) curve. Results Among 85 ECCA patients, there were 22 cases with LVI (LVI positive group) and 63 cases without LVI (LVI negative group). ADC value of LVI negative group was 1.32×10-3 (1.25×10-3, 1.45×10-3) mm2/s, of LVI positive group was 1.17×10-3 (1.08×10-3, 1.31×10-3) mm2/s, and there were statistically difference of ADC values between groups (P<0.05). The area under the curve (AUC) of ADC value for diagnosing positive LVI was 0.80 (95%CI [0.69, 0.91], P<0.05). Taken 1.18×10-3 mm2/s as the threshold of ADC value for predicting positive LVI, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 63.64% (14/22), 90.48% (57/63), 70.00% (14/20), 87.69% (57/65) and 83.53% (71/85), respectively. Conclusion ADC value could be used assess LVI in ECCA patients. |
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