氨基质子转移成像及扩散峰度成像用于宫颈鳞癌病理分级

Amide proton transfer imaging and diffusion kurtosis imaging in differentiating histological grade of cervical squamous cell carcinoma

目的观察氨基质子转移成像(APT)及扩散峰度成像(DKI)鉴别不同病理级别宫颈鳞癌的价值。方法回顾性分析36例原发宫颈鳞癌[高分化组(n=11)、中分化组(n=16)、低分化组(n=9)]患者APT、DKI等资料,分别于非对称性磁化转移率(MTRasym)、平均峰度系数(MK)、平均扩散系数(MD)伪彩图上测量宫颈鳞癌组织的MTRasym、MK及MD值,并比较各组差异;采用ROC曲线分析各参数鉴别不同病理级别宫颈鳞癌的效能,观察各参数与组织学分级的相关性。结果3组间MTRasym、MK、MD值差异均有统计学意义(F=25.82、15.21、15.35,P均<0.01)。MTRasym值鉴别高、中分化及中、低分化宫颈鳞癌的诊断效能均最佳(AUC=0.85,0.90,P均<0.01),分别优于MD(AUC=0.83、0.78,P均<0.01)和MK(AUC=0.82、0.82,P均<0.01)。MK值、MTRasym值与病理分级均呈正相关(r=0.78、0.69,P均<0.01),MD值与病理分级呈负相关(r=-0.68,P<0.01)。结论APT和DKI参数均有助于宫颈鳞癌病理分级;相比DKI,APT的诊断效能更高。

Objective To explore the value of amide proton transfer imaging(APT)and diffusion kurtosis imaging(DKI)in differentiating histological grade of cervical squamous cell carcinoma.Methods APT and DKI data of 36 patients with cervical squamous cell carcinoma,including 11 with high differentiated tumor(high differentiated group),16 with moderate differentiated tumor(moderate differentiated group)and 9 with poor differentiated tumor(poor differentiated group)were retrospectively analyzed.The magnetization transfer ratio asymmetry(MTRasym),mean kurtosis(MK)and mean diffusion(MD)values of tumors were measured on the corresponding pseudo color pictures,respectively.The differences of MTRasym,MK and MD values were compared among 3 groups.ROC curve was used to analyze the diagnostic efficiency of each parameter in differentiating histological grade of cervical squamous cell carcinoma,and the correlation of each parameter with histological grade was analyzed.Results No statistical difference of MTRasym,MK nor MD value was found among 3 groups(F=25.82,15.21,15.35,all P<0.01).MTRasym had the best diagnostic efficacy of differentiating high and moderate,moderate and poor differentiated cervical squamous cell carcinoma(AUC=0.85,0.90,both P<0.01),which was better than MD(AUC=0.83,0.78,P<0.01)and MK(AUC=0.82,0.82,P<0.01),respectively.MK and MTRasym values were positively correlated(r=0.78,0.69,both P<0.01)and MD value was negatively correlated with pathological grade of cervical squamous cell carcinoma(r=-0.68,P<0.01).Conclusion Both APT and DKI parameters are helpful to differentiating pathological grades of cervical squamous cell carcinoma.Compared with DKI,APT has higher diagnostic efficacy.