酰胺质子转移加权成像与扩散峰度成像评估宫颈鳞癌组织学分级的价值比较分析。
Comparative analysis of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in evaluating the histological grade of cervical squamous carcinoma.
机构信息
Department of MRI, Xin Xiang Central Hospital & The Fourth Clinical College of Xinxiang Medical University, 56 Jinsui Road, Xinxiang, 453000, Henan, China.
Department of Orthopedics, the First Affiliated Hospital, Xinxiang Medical University, Weihui, China.
出版信息
BMC Cancer. 2022 Jan 20;22(1):87. doi: 10.1186/s12885-022-09205-z.
BACKGROUND
Uterine cervical cancer (UCC) was the fourth leading cause of cancer death among women worldwide. The conventional MRI hardly revealing the microstructure information. This study aimed to compare the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in evaluating the histological grade of cervical squamous carcinoma (CSC) in addition to routine diffusion-weighted imaging (DWI).
METHODS
Forty-six patients with CSC underwent pelvic DKI and APTWI. The magnetization transfer ratio asymmetry (MTRasym), apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated and compared based on the histological grade. Correlation coefficients between each parameter and histological grade were calculated.
RESULTS
The MTRasym and MK values of grade 1 (G1) were significantly lower than those of grade 2 (G2), and those parameters of G2 were significantly lower than those of grade 3 (G3). The MD and ADC values of G1 were significantly higher than those of G2, and those of G2 were significantly higher than those of G3. MTRasym and MK were both positively correlated with histological grade (r = 0.789 and 0.743, P < 0.001), while MD and ADC were both negatively correlated with histological grade (r = - 0.732 and - 0.644, P < 0.001). For the diagnosis of G1 and G2 CSCs, AUC (APTWI+DKI + DWI) > AUC (DKI + DWI) > AUC (APTWI+DKI) > AUC (APTWI+DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD) > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (DKI + DWI) and AUC (ADC) were significant. For the diagnosis of G2 and G3 CSCs, AUC (APTWI+DKI + DWI) > AUC (APTWI+DWI) > AUC (APTWI+DKI) > AUC (DKI + DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (APTWI+DWI) and AUC (ADC) were significant.
CONCLUSION
Compared with DWI and DKI, APTWI is more effective in identifying the histological grades of CSC. APTWI is recommended as a supplementary scan to routine DWI in CSCs.
背景
宫颈癌（UCC）是全球女性癌症死亡的第四大原因。传统的 MRI 几乎无法显示微观结构信息。本研究旨在比较酰胺质子转移加权成像（APTWI）和扩散峰度成像（DKI）在评估宫颈鳞状细胞癌（CSC）组织学分级中的价值，此外还包括常规扩散加权成像（DWI）。
方法
46 例 CSC 患者进行盆腔 DKI 和 APTWI 检查。根据组织学分级计算并比较磁化转移率不对称（MTRasym）、表观扩散系数（ADC）、平均扩散系数（MD）和平均峰度（MK）。计算每个参数与组织学分级之间的相关系数。
结果
G1 级的 MTRasym 和 MK 值明显低于 G2 级，G2 级的 MTRasym 和 MK 值明显低于 G3 级。G1 级的 MD 和 ADC 值明显高于 G2 级，G2 级的 MD 和 ADC 值明显高于 G3 级。MTRasym 和 MK 均与组织学分级呈正相关（r=0.789 和 0.743，P<0.001），而 MD 和 ADC 与组织学分级呈负相关（r=-0.732 和-0.644，P<0.001）。对于 G1 和 G2 CSC 的诊断，AUC（APTWI+DKI+DWI）>AUC（DKI+DWI）>AUC（APTWI+DKI）>AUC（APTWI+DWI）>AUC（MTRasym）>AUC（MK）>AUC（MD）>AUC（ADC），其中 AUC（APTWI+DKI+DWI）、AUC（DKI+DWI）和 AUC（ADC）之间的差异具有统计学意义。对于 G2 和 G3 CSC 的诊断，AUC（APTWI+DKI+DWI）>AUC（APTWI+DWI）>AUC（APTWI+DKI）>AUC（DKI+DWI）>AUC（MTRasym）>AUC（MK）>AUC（MD）>AUC（ADC），其中 AUC（APTWI+DKI+DWI）、AUC（APTWI+DWI）和 AUC（ADC）之间的差异具有统计学意义。
结论
与 DWI 和 DKI 相比，APTWI 更能有效识别 CSC 的组织学分级。建议在 CSC 中常规 DWI 扫描的基础上增加 APTWI 作为补充扫描。
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