Anhui Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.
Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230031, China.
Contrast Media Mol Imaging. 2021 May 11;2021:6651070. doi: 10.1155/2021/6651070. eCollection 2021.
This study sought to determine the diagnostic value of combined intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) in predicting parametrial infiltration (PMI) in patients with cervical cancer.
We enrolled 65 patients with cervical cancer confirmed by radical hysterectomy (25 PMI-negative and 40 PMI-positive) who underwent IVIM and DTI pretreatment. The parameters of IVIM (ADC, D, D , and f) and DTI (average diffusion coefficient (DCavg) and fractional anisotropy (FA)) were recorded by two observers. All parameter differences were tested, and the receiver operating characteristic (ROC) curves were generated to estimate the diagnostic performance of significant metrics and their combinations.
Compared to the PMI-negative group, the PMI-positive group had significantly lower D (0.632 ± 0.017 0.773 ± 0.024, < 0.001) and lower FA (0.073 ± 0.002 0.085 ± 0.003, =0.003). The area under the ROC curve (AUC) of D and FA was 0.801 and 0.726, respectively, and the combination of D and FA improved the AUC to 0.931, with a sensitivity and specificity of 80.0% and 97.5%, respectively.
D and FA values could be used to help diagnose PMI in patients with cervical cancer. The combination of IVIM and DTI was more valuable than either option alone.
本研究旨在探讨体素内不相干运动（IVIM）扩散加权磁共振成像（MRI）与扩散张量成像（DTI）联合对宫颈癌患者宫旁浸润（PMI）的诊断价值。
本研究共纳入 65 例经根治性子宫切除术证实的宫颈癌患者（25 例 PMI 阴性，40 例 PMI 阳性），所有患者均在术前接受 IVIM 和 DTI 检查。由 2 名观察者记录 IVIM（ADC、D、D*和 f）和 DTI（平均扩散系数（DCavg）和各向异性分数（FA））的参数。比较所有参数差异，绘制受试者工作特征（ROC）曲线评估各参数及组合的诊断效能。
与 PMI 阴性组相比，PMI 阳性组的 D 值（0.632±0.017 比 0.773±0.024，<0.001）和 FA 值（0.073±0.002 比 0.085±0.003，=0.003）明显降低。D 值和 FA 值的 ROC 曲线下面积（AUC）分别为 0.801 和 0.726，D 值和 FA 值联合应用可使 AUC 提高至 0.931，敏感度和特异度分别为 80.0%和 97.5%。
D 值和 FA 值可用于帮助诊断宫颈癌患者的 PMI，IVIM 与 DTI 联合应用较单独应用更有价值。
