付佳,石清磊,李子禹,朱海峰,吴卫平,李晓婷,李佳铮,刘一婷,唐磊.动态对比增强MRI定量参数预测局部进展期胃癌病理类型[J].中国医学影像技术,2021,37(9):1353~1357
动态对比增强MRI定量参数预测局部进展期胃癌病理类型
Predicting pathological types of locally advanced gastric cancer with quantitative parameters of dynamic contrast enhanced MRI
投稿时间:2020-10-08  修订日期:2021-06-30
DOI:10.13929/j.issn.1003-3289.2021.09.018
中文关键词:  胃肿瘤  磁共振成像
英文关键词:stomach neoplasms  magnetic resonance imaging
基金项目:北大百度基金资助项目(2020BD027)。
作者单位E-mail
付佳 北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科, 北京 100142  
石清磊 西门子医疗系统有限公司磁共振事业部, 北京 100096  
李子禹 北京大学肿瘤医院胃肠肿瘤中心 恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100142  
朱海峰 北京民航总医院放射科, 北京 100123  
吴卫平 北京民航总医院放射科, 北京 100123  
李晓婷 北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科, 北京 100142  
李佳铮 北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科, 北京 100142  
刘一婷 北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科, 北京 100142  
唐磊 北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科, 北京 100142 tangL@bjcancer.org 
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中文摘要:
      目的 评价动态对比增强MRI(DCE-MRI)定量参数预测局部进展期胃癌病理分化程度及Lauren分型的价值。方法 纳入48例局部进展期胃癌患者,根据病理分化程度分为低分化(n=19)及中/高分化癌(n=29);根据肿物生长和胃壁浸润模式进行Lauren分型,即弥漫型(n=12)及肠型+混合型(n=36);比较不同分类肿瘤DCE-MRI灌注参数的差异。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各参数预测弥漫型及低分化胃癌的效能。结果 弥漫型胃癌血管外细胞外间隙容积比(Ve)明显高于肠型+混合型(P<0.05),速率常数(Kep)明显低于肠型+混合型(P<0.05);低分化胃癌容积转移常数(Ktrans)及Ve均明显高于中/高分化胃癌(P均<0.05)。Ve预测弥漫型胃癌的AUC为0.79,敏感度为91.70%,特异度为72.20%。各参数预测低分化胃癌的ROC曲线差异均无统计学意义(P均>0.05)。结论 不同Lauren分型及分化程度的局部进展期胃癌DCE-MRI参数存在差异;Ve预测弥漫型胃癌的效能较高。
英文摘要:
      Objective To observe the value of dynamic contrast-enhanced MRI (DCE-MRI) quantitative parameters for predicting pathologic differentiation and Lauren types of locally advanced gastric cancer. Methods A total of 48 patients with locally advanced gastric cancer were enrolled and divided into low differentiated (n=19) and medium/high differentiated (n=29) gastric cancer according to the degree of pathological differentiation. According to the pattern of tumor growth and gastric wall infiltration, Lauren typing was performed, and gastric cancers were divided into diffuse type (n=12) and intestinal+mixed type (n=36). The receiver operating characteristic (ROC) curves were drawn, and the areas under the curves (AUC) were calculated to evaluate the predicting efficiency of parameters of diffuse and low differentiated gastric cancer. Results The extravascular extracellular volume fraction (Ve) of diffuse type cancer was significantly higher than that of intestinal+mixed type (P<0.05), and the rate of constant (Kep) was significantly lower than that of intestinal+mixed type (P<0.05). The volume transport constant (Ktrans) and Ve of low differentiated gastric cancer were significantly higher than those of moderately/highly differentiated gastric cancer (both P<0.05). The AUC, sensitivity and specificity of Ve in prediction of diffuse gastric cancer was 0.79, 91.70% and 72.20%, respectively. The ROC curves of parameters for predicting low differentiated gastric cancer were not statistically different (all P>0.05). Conclusion DCE-MRI parameters of locally advanced gastric cancer were different among different Lauren types and differentiation degrees, among which Ve had higher predictive efficiency for diffuse gastric cancer.
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