体素内不相干运动扩散加权成像参数与早期宫颈癌肿瘤基质比的相关性

Correlation of Intravoxel Incoherent Motion Diffusion Weighted Imaging Parameter and Tumor Stroma Ratio in Early Cervical Cancer

[目的]探讨体素内不相干运动(intravoxel incoherent motion,IVIM)扩散加权成像(diffusion-weighted imaging,DWI)参数与早期宫颈癌肿瘤基质比(TSR)的相关性。[方法]2021年1月1日至2021年12月1日期间选择77例早期宫颈癌患者纳入研究。患者均接受IVIM-DWI成像,并测量D、D*和f值参数。根据TSR将肿瘤分为基质丰富组和基质贫乏组,对两组的IVIM参数进行比较。采用多元回归分析IVIM参数与TSR之间的关系。[结果]基质丰富肿瘤的D值和f值显著性低于基质贫乏肿瘤(P=0.018、0.015)。D值与TSR呈密切负相关(r=-0.642,P=0.015),f值与TSR呈中度负相关(r=-0.503,P=0.028)。D值和f值在区分基质丰富和基质贫乏肿瘤的ROC曲线下面积分别为0.834(95%CI:0.617~0.906)和0.677(95%CI:0.576~0.794)。多元回归分析显示,肿瘤大小(P=0.007)、TSR(P=0.008)、组织学分级(P=0.012)和组织类型(P=0.031)与D值相关。肿瘤大小(P=0.011)、TSR(P=0.021)和组织类型(P=0.037)与f值相关。[结论]IVIM-DWI获得的D值和f值可以反映早期宫颈癌的TSR特征。

[Objective]To investigate the association of parameters derived from intravoxel incoherent motion(IVIM)diffusion-weighted imaging(DWI)with tumor stroma ratio(TSR)in early-stage cervical cancer.[Methods]Between January 2021 and December 2021,77 patients with earlystage cervical cancer were enrolled in this study.All patients underwent IVIM-DWI imaging,and D,D*,and f-values were measured.Tumors were divided into stromal-rich and stromal-poor group according to TSR,and the IVIM parameters of the two groups were compared.Multivariate regression was used to analyze the relationship between IVIM parameters and TSR.[Results]Stoma-rich tumor had significantly lower D and f value than stroma-poor tumor(P=0.018,0.015).The D value and f value were negatively correlated with TSR(r=-0.642,P=0.015;r=-0.503,P=0.028).The areas under the ROC curve(AUC)of D and f value for distinguishing stromal-rich and stromal-poor tumor were 0.834(95%CI:0.617~0.906)and 0.677(95%CI:0.576~0.794),respectively.Multiple linear regression analysis showed tumor size(P=0.007),TSR(P=0.008),histological grade(P=0.012)and histological type(P=0.031)were independently associated with D value,tumor size(P=0.011),TSR(P=0.021)and histological type(P=0.037)were independently associated with f-value.[Conclusion]D value and f value obtained from IVIM-DWI can reflect the TSR characteristics of early cervical cancer.