3.0T MRI水通道蛋白分子成像在胰腺癌的应用价值

The application value of 3.0T MRI molecular imaging of aquaporins in pancreatic cancer

目的:探讨3.0T MRI水通道蛋白分子成像定量参数(ADC_(AQPs))在胰腺癌的应用价值。方法:采用GE Discovery MR750 3.0T磁共振扫描仪对临床或手术病理证实的37例胰腺癌患者行胰腺多b值DWI。应用水通道蛋白AQPs模型、非高斯IVIM双指数模型和拉伸指数模型分析多b值DWI,测量胰腺癌和非癌胰腺组织的水通道蛋白扩散系数(ADC_(AQPs))、纯扩散系数(ADC_(slow))和分布扩散系数(DDC),采用独立样本t检验进行统计学分析。结果:胰腺癌的ADC_(AQPs)值和ADC_(slow)值明显高于非癌胰腺组织(0.346vs.0.202μm^2/ms,P<0.001;0.611vs 0.521×10^(-3) mm^2/s,P=0.037),胰腺癌的DDC值明显低于非癌胰腺组织(1.244vs 1.679×10^(-3) mm^2/s,P=0.013),差异均有统计学意义。与ADC_(slow)和DDC相比,ADC_(AQPs)鉴别胰腺癌和非癌胰腺组织时的诊断效能更高(0.890>0.699>0.640)。胰腺癌的ADC_(AQPs)值和ADC_(slow)值呈正相关(r=0.414,P=0.015)。结论:水通道蛋白扩散系数ADC_(AQPs)和非高斯模型DWI扩散系数(ADC_(slow)、DDC)可以有效鉴别胰腺癌和非癌胰腺组织,ADC_(AQPs)是鉴别胰腺癌和非癌胰腺组织的最佳参数,3.0T MRI水通道蛋白分子成像是无创性早期诊断和鉴别胰腺癌与非癌胰腺组织的理想方法之一。

Objective：To explore the application value of quantitative parameters derived from 3.0T MRI molecular imaging of aquaporins in pancreatic cancer. Methods：Subjects that comprised of 37 patients with pancreatic cancer confirmed by clinical or surgery were included. Pancreas multiple h-value diffusion-weighted imaging （DWI） was performed using GE Discovery MR750 3.0T scanner. ADCAQP, were calculated using AQPs diffusion model. Pure diffusion constant （ADCslow） were calculated using non-Gaussian IVIM diffusion model. Distribute diffusion constant （DDC） were calculated using non- Gaussian stretched exponential diffusion model. Parameters of pancreatic cancers and non-tumorous pancreas were compared using Independent Samples t Test. The P value 〈0.05 was considered significant. Results： Mean ADCAQPs and ADCslow value of pancreatic cancer was significantly higher than that of non-tumorous pancreas （0. 346 vs 0. 202μm^2/ms,P〈0.001 ;0. 611 vs 0. 521 × 10^-3mm^2/s, P= 0. 037 ;respectively）. Mean DDC values of pancreatic cancer were significantly lower than those of non-tumorous pancreas （1. 244 vs 1. 679×10^-3mm^2/s, P= 0. 013）. The diagnostic performance of ADCAQPs in differentiating pancreatic cancer from non-tumorous pancreas was the highest compared with ADCslow and DDC （0. 890〉0. 699〉 0. 640）. ADCAQPs of pancreatic cancer was positively correlated to ADCslow （r= 0. 414, P= 0. 015）. Conclusions： Diffusion coefficients derived from AQPs molecular imaging （ADCAQPs） and non-Gaussian model DWI （ADCslow ,DDC） can distinguish pancreatic cancer from non-tumorous pancreas. ADCAQPs value is the optimal parameter. 3. 0T MRI molecular imaging of aquaporins may be a promising and non invasive tool for early diagnosing and differentiating pancreatic carcinoma.