磁共振纹理分析、弥散加权成像在直肠癌肝转移中的临床应用

Clinical Application of MRI Texture Analysis and Diffusion Weighted Imaging in Detection of Liver Metastasis in Rectal Cancer

目的:探讨直肠癌原发病灶的MRI纹理分析、弥散加权成像在检测同时性肝转移中的价值。方法:收集无锡市中医医院2014年1月—2019年10月确诊为直肠癌的患者作为研究对象,从中筛选出符合条件的直肠癌肝转移、无肝转移患者各17例。对病例人口学资料进行分析,对弥散加权图像进行后处理,得到相应区域的ADC值、EADC值。同时,对AXT2Propeller序列的图像采用纹理分析的方法,分别得到肿瘤的偏度、峰度、熵值等参数,对两组患者相关系数进行统计学分析。结果:两组患者直肠癌原发病灶的ADC、EADC、偏度、熵值、对比度值的差异有统计学意义(t=-2.224、3.000、2.405、3.057、3.255,P<0.05),同时,肝转移组的EADC、偏度、熵值、对比度值参数高于非肝转移组;其余参数值差异无统计学意义(t=-1.635、-1.690、1.155、-1.085,P>0.05),其中对比度参数的ROC曲线下面积最大,当对比度参数诊断界值取11.751时,用于鉴别诊断两者的敏感性和特异性分别为82.4%、76.5%。结论:弥散加权成像的EADC值以及纹理分析的熵值、对比度参数在检测同时性肝转移中具有一定的应用价值,且对比度参数具有较高的诊断价值。

Objective:To investigate the value of MRI texture analysis and diffusion weighted imaging(DWI)in detecting simultaneous liver metastasis in colorectal cancer.Methods:Patients diagnosed with rectal cancer from January 2014 to October 2019 in the hospital were selected as the research objects,and 17 patients with liver metastasis and 17 patients without liver metastasis were screened out.The demographic data of the cases were analyzed,and the diffusion-weighted images were post-processed to obtain the ADC and EADC values of the corresponding regions.At the same time,texture analysis was used for the images of AX T2 Propeller sequence,and parameters such as tumor skewness,kurtosis and entropy were obtained respectively.Statistical analysis was performed on the correlation coefficient between the two groups.Results:There were statistically significant differences in ADC,EADC,skewness,entropy,and contrast between the two groups of rectal cancer primary lesions(t=-2.224,3.000,2.405,3.057,3.255,P<0.05).At the same time,the parameters of EADC,skewness,entropy,and contrast in the liver metastasis group were higher than those in the non-liver metastasis group.The other parameters were not statistically significant(t=-1.635,-1.690,1.155,-1.085,P>0.05).Among them,the area under the ROC curve of the contrast parameter was the largest.When the diagnostic threshold of the contrast parameter was 11.751,the sensitivity and specificity for differential diagnosis were 82.4%and 76.5%,respectively.Conclusion:The EADC value of diffusion-weighted imaging,the entropy value and contrast parameter of texture analysis have certain application value in the detection of synchronous liver metastases,and the contrast parameter has high diagnostic value.