DCE-MRI定量参数对宫颈癌盆腔淋巴结转移的预测价值

The Predictive Value of DCE-MRI Quantitative Parameters for Pelvic Lymph Node Metastasis of Cervical Cancer

目的:探讨动态增强磁共振(DCE-MRI)定量参数对宫颈癌盆腔淋巴结转移的预测价值。方法:以简单随机抽样法纳入2018年6月~2020年12月至我院就诊的62例宫颈癌患者作为研究对象,获取DCE-MRI定量参数,即原发灶容量转移常数(Ktrans)、血管外细胞外间隙容积分数(Ve)、回流速率常数(Kep),记录患者磁共振成像的肿瘤最大径、年龄等定量参数。将患者分为盆腔淋巴结转移阳性和阴性,比较以上定量参数,对有统计学意义的定量参数进行回归性分析,以ROC分析判断盆腔淋巴结转移阳性的预测效能。结果:62例宫颈癌患者中,盆腔淋巴结转移阳性和阴性患者分别为28例和34例,阳性组和阴性组肿瘤最大径、Ktrans两项定量参数差异具有统计学意义(P<0.05)。Ve、Kep无统计学意义(P>0.05)。肿瘤最大径为盆腔淋巴结转移阳性的独立风险因子,肿瘤最大径联合Ktrans预测效果最好,ROC曲线下面积(AUC)为0.941,准确度、灵敏度、特异度分别为78.65%、81.65%、96.84%。结论:DCE-MRI定量参数中Ktrans联合肿瘤最大径用于宫颈癌盆腔淋巴结转移的预测效果好,临床价值高。

Objective:To investigate the predictive value of dynamic enhanced magnetic resonance(DCE-MRI) quantitative parameters for pelvic lymph node metastasis of cervical cancer.Methods:simple random sampling method in June 2018 to December 2020 to our hospital 62 cases of cervical cancer patients as the research object, to obtain the DCE MRI quantitative parameters, namely the primary focal capacity transfer constant(Ktrans), blood vessels, extracellular clearance volume fraction(Ve), the return rate constant(Kep), records of magnetic resonance imaging in patients with tumor maximum diameter, quantitative parameters such as the age. The patients were divided into positive and negative pelvic lymph node metastasis, and the above quantitative parameters were compared. Regression analysis was conducted on the quantitative parameters with statistical significance, and the predictive efficacy of positive pelvic lymph node metastasis was determined by ROC analysis.Results:Among the 62 patients with cervical cancer, 28 patients had positive and 34 patients had negative pelvic lymph node metastasis, respectively, and the differences in tumor maximum diameter and Ktrans quantitative parameters between the positive and negative groups were statistically significant(P<0.05). Ve and Kep showed no statistical significance(P>0.05). The maximum tumor diameter was an independent risk factor for positive pelvic lymph node metastasis;the maximum tumor diameter combined with Ktrans had the best prediction effect;the area under ROC curve(AUC) was 0.941;the accuracy, sensitivity and specificity were 78.65%, 81.65% and 96.84%, respectively.Conclusion:The DCE-MRI quantitative parameters of Ktrans combined with the maximum tumor diameter for the prediction of pelvic lymph node metastasis of cervical cancer have a good effect and high clinical value.