扩散峰度成像定量评估在深层子宫肌层浸润中的应用：与扩散加权成像的对比分析。
Quantitative assessment of diffusion kurtosis imaging depicting deep myometrial invasion: a comparative analysis with diffusion-weighted imaging.
机构信息
Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Gynaecology and Obstetrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
出版信息
Diagn Interv Radiol. 2020 Mar;26(2):74-81. doi: 10.5152/dir.2019.18366.
PURPOSE
We aimed to investigate histogram analysis of diffusion kurtosis imaging (DKI) and conventional diffusion-weighted imaging (DWI) to distinguish between deep myometrial invasion and superficial myometrial invasion in endometrial carcinoma (EC).
METHODS
A total of 118 pathologically confirmed EC patients with preoperative DWI were included. The data were postprocessed with a DKI (b value of 0, 700, 1400, and 2000 s/mm2) model for quantitation of apparent diffusion values (D) and apparent kurtosis coefficient values (K) for non-Gaussian distribution. The apparent diffusion coefficient (ADC) was postprocessed with a conventional DWI model (b values of 0 and 800 s/mm2). A whole-tumor analysis approach was used. Comparisons of the histogram parameters of D, K, and ADC were carried out for the deep myometrial invasion and superficial myometrial invasion subgroups. Diagnostic performance of the imaging parameters was assessed.
RESULTS
The Dmean, D10th, and D90th in deep myometrial invasion group were significantly lower than those in superficial invasion group (P < 0.001, P < 0.001, and P = 0.023, respectively), as well as the ADCmean, ADC10th, and ADC90th (P = 0.001, P = 0.001, and P = 0.042, respectively). The Kmean and K90th were significantly higher in deep invasion group than those in superficial myometrial invasion group (P = 0.002 and P = 0.026, respectively). The D10th, Kmean, and ADC10th had a relatively higher area under the curve (AUC) (0.72, 0.66, and 0.71, respectively) than other parameters for distinguishing deep myometrial invasion of EC. D10th showed a relatively higher AUC than ADC10th for the differentiation of lesions with deep myometrial invasion from those with superficial myometrial invasion (0.72 vs. 0.71), but the variation was not statistically significant (P = 0.35).
CONCLUSION
Distribution of DKI and conventional DWI parameters characterized by histogram analysis may represent an indicator for deep myometrial invasion in EC. Both DKI and DWI models showed relatively equivalent effectiveness.
目的
本研究旨在通过扩散峰度成像（DKI）和常规扩散加权成像（DWI）的直方图分析，区分子宫内膜癌（EC）的深层肌层浸润和浅层肌层浸润。
方法
本研究共纳入 118 例经病理证实的 EC 患者，术前均行 DWI 检查。使用 DKI（b 值为 0、700、1400 和 2000 s/mm2）模型对表观扩散值（D）和非高斯分布的表观峰度系数值（K）进行定量分析，使用常规 DWI 模型（b 值为 0 和 800 s/mm2）对表观扩散系数（ADC）进行后处理。采用全肿瘤分析方法，比较深层肌层浸润和浅层肌层浸润亚组的 D、K 和 ADC 直方图参数。评估各影像学参数的诊断性能。
结果
深层肌层浸润组的 Dmean、D10th 和 D90th 值明显低于浅层肌层浸润组（P＜0.001、P＜0.001 和 P=0.023），ADCmean、ADC10th 和 ADC90th 值也明显低于浅层肌层浸润组（P=0.001、P=0.001 和 P=0.042）。深层肌层浸润组的 Kmean 和 K90th 值明显高于浅层肌层浸润组（P=0.002 和 P=0.026）。D10th、Kmean 和 ADC10th 用于区分 EC 深层肌层浸润的曲线下面积（AUC）相对较高（分别为 0.72、0.66 和 0.71）。D10th 用于区分深层肌层浸润病变与浅层肌层浸润病变的 AUC 高于 ADC10th（0.72 与 0.71），但差异无统计学意义（P=0.35）。
结论
DKI 和常规 DWI 直方图参数分布可作为 EC 深层肌层浸润的指标，两者均具有相对等效的效果。
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