Qiu Lin, Liu Xiao-Ling, Liu Si-Run, Weng Ze-Ping, Chen Xiao-Qiao, Feng You-Zhen, Cai Xiang-Ran, Guo Chang-Yu
Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China.
Department of Pathology, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China.
J Magn Reson Imaging. 2016 Oct;44(4):1031-9. doi: 10.1002/jmri.25250. Epub 2016 Mar 28.
To evaluate the diagnostic value of intravoxel incoherent motion imaging (IVIM) in differentiating metastatic and nonmetastatic lymph nodes in patients with rectal carcinoma.
In all, 68 patients with histologically proven rectal carcinoma underwent an IVIM sequence (b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, 1500, and 2000 s/mm(2) ) on a 3.0T MRI scanner. The IVIM parameters (D, D*, f, and apparent diffusion coefficient [ADC] values) in metastatic and nonmetastatic lymph nodes were measured and calculated. Receiver-operating characteristic (ROC) analyses were conducted to determine the optimal thresholds, the sensitivities, and specificities for differentiation.
Mean D, f, and ADC values of metastatic lymph nodes were significantly greater than those of the normal lymph nodes (P < 0.01), whereas the mean D* value of metastatic lymph node was statistically lower (P = 0.03). The AUC, sensitivity, specificity, and the cutoff value, respectively, for differentiating metastatic from nonmetastatic lymph nodes for D, D*, f, and ADC were as follows: D, 0.9460, 89.25%, 91.04%, and 1.14 × 10(-3) mm(2) /s; D*, 0.6930, 64.18%, 82.80%, and 7.02 × 10(-3) mm(2) /s; f, 0.7810, 92.47%, 55.22%, and 0.27%; ADC, 0.8970, 87.10%, 88.06%, and 0.80 × 10(-3) mm(2) /s. The ROC curves demonstrated that the area under the ROC (AUC) of the D, ADC, f, and D* values successively decreased, and D had the highest AUC, with D* values being lowest.
An IVIM sequence may be helpful in diagnosing metastatic lymph nodes of rectal carcinoma. Average D and ADC values are more sensitive than f and D* values in this differentiation. J. MAGN. RESON. IMAGING 2016;44:1031-1039.
评估体素内不相干运动成像（IVIM）在鉴别直肠癌患者转移性和非转移性淋巴结中的诊断价值。
总共68例经组织学证实的直肠癌患者在3.0T磁共振成像扫描仪上接受了IVIM序列扫描（b = 0、25、50、75、100、150、200、400、600、800、1000、1200、1500和2000 s/mm²）。测量并计算转移性和非转移性淋巴结中的IVIM参数（D、D*、f和表观扩散系数[ADC]值）。进行受试者操作特征（ROC）分析以确定用于鉴别诊断的最佳阈值、敏感性和特异性。
转移性淋巴结的平均D、f和ADC值显著高于正常淋巴结（P < 0.01），而转移性淋巴结的平均D值在统计学上较低（P = 0.03）。D、D、f和ADC用于鉴别转移性和非转移性淋巴结的曲线下面积（AUC）、敏感性、特异性及截断值分别如下：D，0.9460、89.25%、91.04%和1.14×10⁻³ mm²/s；D*，0.6930、64.18%、82.80%和7.02×10⁻³ mm²/s；f，0.7810、92.47%、55.22%和0.27%；ADC，0.8970、87.10%、88.06%和0.80×10⁻³ mm²/s。ROC曲线表明，D、ADC、f和D值的ROC曲线下面积（AUC）依次降低，且D的AUC最高，D值最低。
IVIM序列可能有助于诊断直肠癌的转移性淋巴结。在此鉴别诊断中，平均D和ADC值比f和D*值更敏感。《磁共振成像杂志》2016年；44：1031 - 1039。
