Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uteri...Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uterine cervical cancer to radiochemotherapy(CRT).Methods This prospective study was approved by the institutional review board, and informed consent was obtained from all patients. A total of 23 patients with primary cervical cancer who were undergoing CRT and 16 age-matched healthy subjects were prospectively recruited for IVIM(b = 0–800 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive f(perfusion fraction), D*(pseudo-diffusion coefficient), and D(true molecular diffusion coefficient) in cervical cancer(n = 23) and the normal cervix(n = 16). The apparent diffusion coefficient(standard ADC) was calculated. The independent-samples t-test and paired-samples t-test were used for comparisons.Results Pre-treatment cervical cancer had the lowest standard ADC(1.15 ± 0.13 × 10-3 mm2/s) and D(0.89 ± 0.10 × 10-3 mm2/s) values, and these were significantly different from the normal cervix and posttreatment cervical cancer(P = 0.00). The f(16.67 ± 5.85%) was lowest in pre-treatment cervical cancer and was significantly different from the normal cervix and post-treatment cervical cancer(p = 0.012 and 0.00, respectively). No difference was observed in D*.Conclusion IVIM is potentially promising for differentiating between the normal cervix and cervical cancer because pre-treated cervical cancer has low perfusion and diffusion IVIM characteristics. Further, the standard ADC, D, and f of cervical cancer showed a tendency to normalize after CRT; thus, IVIM may be useful for monitoring the response to CRT in cervical cancer.展开更多
目的探讨体素不相干运动扩散加权(IVIM)-MRI对人脑胶质瘤的病理分级及异柠檬酸盐脱氢酶1(IDH1)突变的评估价值。方法回顾性分析2016年1月至2019年12月术后病理确诊的100例脑胶质瘤的临床资料。术前应用3.0 T MRI扫描仪检查,获取IVIM-MR...目的探讨体素不相干运动扩散加权(IVIM)-MRI对人脑胶质瘤的病理分级及异柠檬酸盐脱氢酶1(IDH1)突变的评估价值。方法回顾性分析2016年1月至2019年12月术后病理确诊的100例脑胶质瘤的临床资料。术前应用3.0 T MRI扫描仪检查,获取IVIM-MRI参数,包括灌注比例系数(F)、真实扩散系数(D)、伪扩散系数(D*)与表观扩散系数(ADC)。结果与高级别胶质瘤相比,低级别胶质瘤ADC值与D值明显增高(P<0.05),而F值与D*值均显著降低(P<0.05)。无论是低级别胶质瘤,还是高级别胶质瘤,IDH1基因突变型病人ADC值显著高于IDH1基因突野生型(P<0.05)。高级别胶质瘤病人中,IDH1基因突变型病人F值、D*值均显著低于IDH1基因野生型(P<0.05)。ROC曲线分析显示,对于鉴别胶质瘤级别,ADC值的最佳临界值为1.091,灵敏度为86.92%,特异度为89.45%;D值的最佳临界值为0.934,灵敏度为78.26%,特异度为94.71%;D*值的最佳临界值为6.161,灵敏度为73.95%,特异度为73.66%;F值的最佳临界值为0.190,灵敏度为56.55%,特异度为100.00%。对于区分IDH1基因型,低级别胶质瘤病人中,ADC值区分IDH1基因突变的最佳临界值为1.181,灵敏度为92.87%,特异度为80.01%;高级别胶质瘤病人中,F值的效能最高,灵敏度为100.00%,特异度为92.87%。结论IVIM-MRI定量分析可用于胶质瘤术前诊断与分级,并对预测胶质瘤IDH1基因状态具有潜在意义。展开更多
基金Supported by grants from the the National Natural Science Foundation of China(No.81371524,81271529)the Hubei Provincial Natural Science Foundation of China(No.2014CFB298)
文摘Objective The aim of this study was to investigate the ability of intravoxel incoherent motion(IVIM) diffusion-weighted magnetic resonance imaging(MRI) to diagnose cervical cancer and to evaluate the response of uterine cervical cancer to radiochemotherapy(CRT).Methods This prospective study was approved by the institutional review board, and informed consent was obtained from all patients. A total of 23 patients with primary cervical cancer who were undergoing CRT and 16 age-matched healthy subjects were prospectively recruited for IVIM(b = 0–800 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive f(perfusion fraction), D*(pseudo-diffusion coefficient), and D(true molecular diffusion coefficient) in cervical cancer(n = 23) and the normal cervix(n = 16). The apparent diffusion coefficient(standard ADC) was calculated. The independent-samples t-test and paired-samples t-test were used for comparisons.Results Pre-treatment cervical cancer had the lowest standard ADC(1.15 ± 0.13 × 10-3 mm2/s) and D(0.89 ± 0.10 × 10-3 mm2/s) values, and these were significantly different from the normal cervix and posttreatment cervical cancer(P = 0.00). The f(16.67 ± 5.85%) was lowest in pre-treatment cervical cancer and was significantly different from the normal cervix and post-treatment cervical cancer(p = 0.012 and 0.00, respectively). No difference was observed in D*.Conclusion IVIM is potentially promising for differentiating between the normal cervix and cervical cancer because pre-treated cervical cancer has low perfusion and diffusion IVIM characteristics. Further, the standard ADC, D, and f of cervical cancer showed a tendency to normalize after CRT; thus, IVIM may be useful for monitoring the response to CRT in cervical cancer.
文摘目的探讨体素不相干运动扩散加权(IVIM)-MRI对人脑胶质瘤的病理分级及异柠檬酸盐脱氢酶1(IDH1)突变的评估价值。方法回顾性分析2016年1月至2019年12月术后病理确诊的100例脑胶质瘤的临床资料。术前应用3.0 T MRI扫描仪检查,获取IVIM-MRI参数,包括灌注比例系数(F)、真实扩散系数(D)、伪扩散系数(D*)与表观扩散系数(ADC)。结果与高级别胶质瘤相比,低级别胶质瘤ADC值与D值明显增高(P<0.05),而F值与D*值均显著降低(P<0.05)。无论是低级别胶质瘤,还是高级别胶质瘤,IDH1基因突变型病人ADC值显著高于IDH1基因突野生型(P<0.05)。高级别胶质瘤病人中,IDH1基因突变型病人F值、D*值均显著低于IDH1基因野生型(P<0.05)。ROC曲线分析显示,对于鉴别胶质瘤级别,ADC值的最佳临界值为1.091,灵敏度为86.92%,特异度为89.45%;D值的最佳临界值为0.934,灵敏度为78.26%,特异度为94.71%;D*值的最佳临界值为6.161,灵敏度为73.95%,特异度为73.66%;F值的最佳临界值为0.190,灵敏度为56.55%,特异度为100.00%。对于区分IDH1基因型,低级别胶质瘤病人中,ADC值区分IDH1基因突变的最佳临界值为1.181,灵敏度为92.87%,特异度为80.01%;高级别胶质瘤病人中,F值的效能最高,灵敏度为100.00%,特异度为92.87%。结论IVIM-MRI定量分析可用于胶质瘤术前诊断与分级,并对预测胶质瘤IDH1基因状态具有潜在意义。
文摘目的·探讨体素不相干运动(intravoxel incoherent motion,IVIM)与动态对比增强(dynamic contrast enhancement,DCE)磁共振成像(magnetic resonance imaging,MRI)术前评估早期宫颈癌淋巴脉管浸润(lymphovascular space invasion,LVSI)状态的临床价值。方法·收集早期宫颈癌患者56例,均在术前行IVIM与DCE MRI检查,分别测量癌灶最大径、肌层浸润深度(比例)以及MRI定量参数(IVIM:f、D、D^*;DCE:Ktrans、Kep、Ve)。根据术后病理结果,将病例分为LVSI阳性组与LVSI阴性组,并记录患者年龄、FIGO分期、病理类型和分化程度。比较2组患者基本资料和MRI参数的差异,Logistic回归分析早期宫颈癌发生LVSI的关联因素,受试者操作特征曲线分析这些关联因素用于评估LVSI情况的诊断效能。结果·LVSI阳性组与LVSI阴性组间患者年龄、FIGO分期、病理类型、肿瘤分化程度、肿瘤最大径比较,差异无统计学意义;LVSI阳性组癌灶肌层浸润深度(比例)显著高于LVSI阴性组(P=0.000),而Ktrans值、D^*值显著低于LVSI阴性组(P=0.003,P=0.004);D值、f值、Kep值、Ve值在2组间比较,差异无统计学意义;Logistic回归分析显示肌层浸润深度(比例)和Ktrans值与早期宫颈癌发生LVSI独立相关;两者独立诊断LVSI状态的曲线下面积(area under the curve,AUC)与准确度分别为0.760与75.1%、0.723与71.4%;联合诊断的AUC为0.839,准确度为76.8%;纳入D^*值后三者诊断的AUC为0.874,准确度为87.5%。结论·宫颈癌肌层浸润深度(比例)、Ktrans值有助于术前评估早期宫颈癌LVSI状态,两者进一步联合D^*值可提高其诊断效能。
