肝外胆管癌IVIM-DWI参数值与Ki-67表达的相关性

Correlation between Parameter Values of Intravoxel Incoherent Motion MR Imaging and Ki-67 Expression in Extrahepatic Cholangiocarcinoma

目的探讨肝外胆管癌(EHCC)体素内不相干运动磁共振扩散加权成像(IVIM-DWI)参数值与Ki-67表达之间的相关性。方法搜集经手术病理证实的41例EHCC患者完整资料,术前均行3.0 T磁共振常规及IVIM-DWI序列扫描,术后采用免疫组织化学染色记录分子预后标记物Ki-67的表达情况。按Ki-67表达差异,将患者分为4组,分别计算各组肿瘤的IVIM-DWI参数值,包括真性扩散系数(D)值、灌注分数(f)值和假性扩散系数(D~*)值。采用Spearman相关分析研究IVIM-DWI各参数与Ki-67表达的相关性。结果 41例EHCC患者按照Ki-67的表达情况分为4组,Ⅰ组5例,Ⅱ组13例,Ⅲ组16例,Ⅳ组7例。不同Ki-67表达组间除D~*值的差异无统计学意义(P>0.05)外,其余参数的差异均有统计学意义(P<0.05)。D值和f值均与Ki-67表达水平呈负相关(r值分别为-0.753、-0.526,P均<0.05)。结论 IVIM-DWI技术可以在一定程度上反映EHCC肿瘤细胞的增殖活性,对术前预测肿瘤恶性增殖的生物学行为具有临床价值。

Objective To investigate the correlation between parameter values of intravoxel incoherent motion(IVIM) MR diffusion-weighted imaging(DWI)and Ki-67 expression in extrahepatic cholangiocarcinoma. Methods 41 patients with EHCC confirmed pathologically underwent preoperative conventional MRI and IVIM sequence scan. The expression of molecular prognostic marker Ki-67 was recorded by immunohistochemical staining. According to the Ki-67 expression difference,the patients were divided into Ⅰ-Ⅳ four Groups. The parameter values such as pure molecular diffusion(D),perfusion fraction(f) and perfusion-based molecular diffusion(D*) were calculated in each group. Spearman correlation analysis was used to study the correlation between the parameters of IVIM-DWI and the Ki-67 expression. Results 41 cases of EHCC were divided into 5 cases in group Ⅰ,13 cases in group Ⅱ,16 in group Ⅲ and 7 in group Ⅳ according to the expression of Ki-67. The difference of D* values between different Ki-67 groups was not statistically significant(P>0.05),and the differences of the other parameters were statistically significant(P<0.05). D and f values correlated negatively with Ki-67 expression(r=-0.753,-0.526,P<0.05). Conclusion IVIM-DWI technology can reflect the proliferative activity of tumor cells of extrahepatic cholangiocarcinoma to a certain extent,and has clinical value for predicting the biological behavior of malignant proliferation before operation.