Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
Siemens Healthineers Ltd., Shanghai 200124, China.
Biomed Res Int. 2022 Apr 19;2022:4370341. doi: 10.1155/2022/4370341. eCollection 2022.
To analyze the value of multiparameter magnetic resonance (mpMRI) in the diagnosis of pancreatic cancer with vascular invasion from two aspects: morphology and function, so as to provide a reliable diagnostic basis for preparing the clinical treatment plans.
Totally 31 case data of pancreatic cancer patients diagnosed in our hospital from January 2020 to March 2021 were enrolled in this study. All patients underwent multiparameter magnetic resonance imaging (T1WI, T2WI, DKI, and DCE-MRI) before surgery, and then all patients underwent pancreatic cancer surgery. Two experienced radiologists analyzed these obtained images according to the image reports and combined them with the pathological results. Taking pathological results as gold standard, the sensitivity, specificity, and accuracy of quantitative parameters derived from T2WI, DKI, DCE, T2WI + DKI, T2WI + DCE, and T2WI + DKI + DCE for the diagnostic capabilities of pancreatic cancer vascular invasion were calculated using diagnostic laboratory methods. Kappa consistency test was used to estimate the consistency of two radiologists' diagnosis and analysis. The images obtained by DKI sequence were input into the postprocessing software MITK-Diffusion v2014.10.02, The images obtained from DCE sequence were processed by the Tissue 4D software on the Siemens syngo via workstation to calculate and analyze each tumor ROI's MD, MK values from DKI, and , , values from DCE. Independent samples -test was used to compare the parameters of pancreatic cancer with vascular invasion group (16 cases) and nonvascular invasion group (15 cases). ROC curve was used to analyze the efficacy of each parameter in diagnosing pancreatic cancer vascular invasion.
The sensitivity, specificity, and accuracy of T2WI were 62.5%, 53.5%, and 58.1%; those of DKI were 56.3%, 60.0%, and 58.1%; those of DCE were 68.8%, 60.0%, and 64.5%; those of T2WI + DKI were 68.8%, 66.7%, and 67.7%; those of T2WI + DCE were 75.0%, 66.7%, and 71.1%; those of T2WI + DKI + DCE were 81.2%, 73.3%, and 77.4%, respectively. These two diagnostic radiologists analyzed image data with good consistency, Kappa = 0.834. MD, MK, , , and were significantly different between the vascular invasion group and the nonvascular invasion group ( < 0.05). Each parameter's AUC of ROC curve was 0.773, 0.829, 0.794, 0.802, and 0.846 ( < 0.05). Take MD = 2.285 × 10 mm/s, MK = 0.72, = 0.103, = 0.337, and = 0.353 as thresholds; the sensitivity of these parameters to diagnose vascular invasion of pancreatic cancer was 73.33%, 75%, 87.5%, 68.8%, and 68.8%. The specificity of them was 75%, 80%, 60%, 86.7%, and 86.7%, respectively.
The combined analysis of T2WI + DKI + DCE can improve the specificity and accuracy of diagnostic efficiency of vascular invasion of pancreatic cancer and provide an important diagnostic basis for pancreatic cancer's preoperative treatment.
从形态学和功能学两方面分析多参数磁共振（mpMRI）在诊断伴有血管侵犯的胰腺癌中的价值，为临床制定治疗方案提供可靠的诊断依据。
选取我院 2020 年 1 月至 2021 年 3 月收治的 31 例胰腺癌患者，所有患者均在术前接受多参数磁共振成像（T1WI、T2WI、DKI 和 DCE-MRI）检查，然后所有患者均接受胰腺癌手术。由 2 名有经验的放射科医生根据图像报告和病理结果对这些获得的图像进行分析。以病理结果为金标准，采用诊断实验室方法计算 T2WI、DKI、DCE、T2WI+DKI、T2WI+DCE 和 T2WI+DKI+DCE 定量参数对诊断胰腺癌血管侵犯的诊断效能，计算每个肿瘤 ROI 的 MD、MK 值和 DKI、 、 、DCE 的 值。采用 Kappa 一致性检验评估两位放射科医生诊断和分析的一致性。将 DKI 序列获得的图像输入到后处理软件 MITK-Diffusion v2014.10.02，将 DCE 序列获得的图像通过西门子 syngo 工作站上的 Tissue 4D 软件进行处理，计算和分析每个肿瘤 ROI 的 DKI 的 MD、MK 值和 DCE 的 、 、 、 值。采用独立样本 t 检验比较伴有血管侵犯组（16 例）和无血管侵犯组（15 例）的参数。采用 ROC 曲线分析各参数诊断胰腺癌血管侵犯的效能。
T2WI 的灵敏度、特异度和准确度分别为 62.5%、53.5%和 58.1%；DKI 分别为 56.3%、60.0%和 58.1%；DCE 分别为 68.8%、60.0%和 64.5%；T2WI+DKI 分别为 68.8%、66.7%和 67.7%；T2WI+DCE 分别为 75.0%、66.7%和 71.1%；T2WI+DKI+DCE 分别为 81.2%、73.3%和 77.4%。这两位诊断放射科医生分析图像数据具有良好的一致性，Kappa = 0.834。血管侵犯组和无血管侵犯组的 MD、MK、 、 、和 差异均有统计学意义（ < 0.05）。ROC 曲线各参数的 AUC 分别为 0.773、0.829、0.794、0.802 和 0.846（ < 0.05）。以 MD = 2.285×10 mm/s、MK = 0.72、 = 0.103、 = 0.337 和 = 0.353 为阈值，这些参数诊断胰腺癌血管侵犯的灵敏度分别为 73.33%、75%、87.5%、68.8%和 68.8%，特异度分别为 75%、80%、60%、86.7%和 86.7%。
T2WI+DKI+DCE 的联合分析可以提高诊断胰腺癌血管侵犯的特异性和准确性，为胰腺癌的术前治疗提供重要的诊断依据。
