能谱CT定量和多参数磁共振成像对肺腺癌EGFR突变相关性的诊断价值

Diagnostic value of quantitative energy spectrum CT and multi-parameter magnetic resonance imaging on EGFR mutation in lung adenocarcinoma

目的探讨能谱CT定量和多参数磁共振成像(magnetic resonance imaging,MRI)对肺腺癌表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的诊断价值。方法回顾性分析2020年6月至2022年6月景德镇市中医医院经病理确诊的93例肺腺癌并EGFR突变患者的临床资料,根据EGFR突变状态分为突变组(52例)和野生组(41例),均予以能谱CT定量和MRI检查。比较两组患者的参数变化。结果突变组患者动脉期和静脉期的CT_(40kev)、CT_(70kev)、能谱曲线斜率(λHU)、有效原子序数、碘浓度均显著高于野生组(P<0.05)。突变组患者的表观扩散系数(apparent diffusion coefficient,ADC)、真扩散系数(D)均显著高于野生组,容积转运常数(K_(trans))、回流速率常数(K_(ep))均显著低于野生组(P<0.05)。受试者操作特征曲线分析显示,CT_(40kev)、CT_(70kev)、λHU、有效原子序数、碘浓度、CT综合参数、ADC、D、K_(trans)、K_(ep)、MRI综合参数诊断肺腺癌EGFR突变状态的曲线下面积(area under the curve,AUC)分别为0.615、0.622、0.680、0.715、0.655、0.855、0.899、0.795、0.740、0.751、0.968;CT综合参数与MRI综合参数的AUC比较差异有统计学意义(P<0.05)。结论能谱CT定量与多参数MRI对肺腺癌EGFR突变状态均具有较高的诊断价值,且MRI的诊断价值更高,有助于为EGFR突变状态的准确评估提供客观依据。

Objective To investigate the diagnostic value of quantitative energy spectrum CT and multi-parameter magnetic resonance imaging(MRI)on epidermal growth factor receptor(EGFR)mutation in lung adenocarcinoma.Methods Clinical data of 93 patients diagnosed with lung adenocarcinoma and EGFR mutation status by pathology in Jingdezhen Hospital of Traditional Chinese Medicine from June 2020 to June 2022 were retrospectively analyzed.They were divided into mutation group(52 cases)and wild-type group(41 cases)according to EGFR mutation status,and all patients were given quantitative spectral CT and MRI examinations.Changes in parameters between two groups were compared.Results CT_(40kev),CT_(70kev),spectral curve slope(λHU),effective atomic number and iodine concentration in arterial and venous phases in mutation group were significantly higher than those in wild-type group(P<0.05).Apparent diffusion coefficient(ADC)and true diffusion coefficient(D)of mutant group were significantly higher than those of wild-type group,while volume transport constant(K_(trans))and reflux rate constant(K_(ep))of mutant group were significantly lower than those of wild-type group(P<0.05).Analysis of receiver operating characteristics curve showed that area under the curve(AUC)value for CT_(40kev),CT_(70kev),λHU,effective atomic number,iodine concentration,CT comprehensive parameters,ADC,D,K_(trans),K_(ep)and MRI comprehensive parameters for diagnosing EGFR mutation status in lung adenocarcinoma were 0.615,0.622,0.680,0.715,0.655,0.855,0.899,0.795,0.740,0.751 and 0.968 respectively.There was statistically significant difference in AUC between CT comprehensive parameters and MRI comprehensive parameters(P<0.05).Conclusion Both quantitative energy spectrum CT and multi-parameter MRI have high diagnostic value in the diagnosis of EGFR mutation status of lung adenocarcinoma,but MRI has higher diagnostic value,which is helpful to provide objective basis for accurate assessment of EGFR mutation status.