体素内不相干运动成像对于周围型肺癌血供情况及细胞密集程度的价值研究

Value of IVIM-DWI Imaging in the Blood Supply and Cell Density of Peripheral Lung Cancer

目的:探究周围型肺癌3.0 T磁共振成像(MRI)的体素内不相干运动成像(IVIM-DWI)各参数值对其血供情况以及细胞密集程度的价值。方法:选取2019年1月-2021年10月于本院行手术切除后并经病理检查证实为周围型肺癌的患者50例,术前均行常规MRI平扫、增强以及IVIM-DWI成像,分别测量所有病灶以及对侧相对称正常肺组织的标准表观扩散系数(s ADC)、真实扩散系数(D)、灌注相关扩散系数(D*)以及灌注分数(f)。比较两者IVIM-DWI参数;比较不同强化程度下周围型肺癌病灶IVIM-DWI参数;Spearman秩相关分析周围型肺癌病灶IVIM-DWI参数与强化程度的相关性;通过绘制受试者工作特征(ROC)曲线,分析与强化程度存在相关性的IVIM-DWI参数对周围型肺癌血供情况及细胞密集程度的评估价值。结果:周围型肺癌病灶的s ADC、D均低于正常肺组织,D*、f均高于正常肺组织,差异均具有统计学意义(P<0.05)。高度强化下周围型肺癌病灶D*高于中度强化、轻度强化,f低于中度强化、轻度强化,而D仅高于轻度强化,差异均具有统计学意义(P<0.05),不同强化程度间s ADC均无统计学差异(P>0.05)。Spearman秩相关分析显示周围型肺癌病灶的D*与强化程度呈正相关(P<0.05),f与强化程度呈负相关(P<0.05)。通过绘制ROC曲线分析显示D*、f对周围型肺癌血供情况以及细胞密集程度评估的AUC大于0.700,提示其具有较高的评估价值。结论:IVIM-DWI模型既可以反映周围型肺癌的血供情况,也可以反映病变细胞密集程度,有助于提高对周围性肺癌血管情况及细胞密集程度的评估价值。

Objective: To explore the value of each parameter value of 3.0 T magnetic resonance(MRI) intra-voxel incoherent motion imaging(IVIM-DWI) in peripheral lung cancer on its blood supply and cell density. Methods: A total of 50 patients who underwent surgical resection in our hospital from January 2019 to October 2021 and were confirmed to be peripheral lung cancer by pathological examination were selected. All patients underwent conventional MRI scan, enhanced and IVIM-DWI imaging before surgery. Standardized apparent diffusion coefficient(s ADC), true diffusion coefficient(D), perfusion-related diffusion coefficient(D*), and perfusion fraction(f) of lesions and contralateral symmetric normal lung tissue. Compare the IVIM-DWI parameters of the two;compare the IVIM-DWI parameters of peripheral lung cancer lesions with different enhancement degrees;Spearman rank correlation analysis of the correlation between the IVIM-DWI parameters and the enhancement degree of peripheral lung cancer lesions;curve to analyze the evaluation value of highly correlated IVIM-DWI parameters for peripheral lung cancer blood supply and cell density. Results: The s ADC and D of peripheral lung cancer lesions were lower than those of normal lung tissue, while D* and f were higher than those of normal lung tissue, and the differences were statistically significant(P<0.05). The D* and f of peripheral lung cancer lesions with high enhancement were lower than those of moderate enhancement and mild enhancement, while D was only higher than that of mild enhancement, and the differences were statistically significant(P<0.05). Statistical difference(P>0.05). Spearman rank correlation analysis showed that D* of peripheral lung cancer lesions was positively correlated with enhancement degree(P<0.05), and f was negatively correlated with enhancement degree(P<0.05). The ROC curve analysis showed that the AUC of D* and f for evaluating the blood supply and cell density of peripheral lung cancer was greater than 0.700, suggesting that they have a high evaluation value. Conclusion: IVIM-DWI model can not only reflect the blood supply of peripheral lung cancer, but also reflect the density of diseased cells, which helps to improve the evaluation value of the blood vessels and cell density of peripheral lung cancer.