不同数学模型的体素内不相干运动 DWI 在预测伴有和不伴有癌变的直肠腺瘤中的应用。
Intravoxel incoherent motion DWI with different mathematical models in predicting rectal adenoma with and without canceration.
机构信息
Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China.
Department of Radiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China.
出版信息
Eur J Radiol. 2022 Oct;155:110496. doi: 10.1016/j.ejrad.2022.110496. Epub 2022 Aug 24.
PURPOSE
To evaluate the clinical value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) with mono-exponential (ME), bi-exponential (BE), and stretched-exponential (SE) models for predicting rectal adenomas with canceration.
MATERIAL AND METHODS
Sixty patients with postoperative pathology-confirmed rectal adenoma (n = 31) and adenoma with canceration (n = 29) were enrolled and underwent IVIM-DWI scanning. The ME-derived apparent diffusion coefficient (ADC), BE-derived true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), SE-derived distributed diffusion coefficient (DDC), and water molecular diffusion heterogeneity index (α) were measured. The differences in each parameter between adenoma and canceration were compared. Multivariate binary logistic regression analysis was used to establish models for predicting rectal adenomas with canceration. Receiver operating characteristic curve analysis was applied to evaluate diagnostic performances of each model in terms of sensitivity, specificity, accuracy, and area under the curve (AUC).
RESULTS
The AUCs of ADC, D, D*, f, DDC and α were 0.851 (95 % confidence interval, CI, 0.735-0.930), 0.895 (95 % CI, 0.789-0.960), 0.720 (95 % CI, 0.589-0.828), 0.791 (95 % CI, 0.667-0.886), 0.841 (95 % CI, 0.724-0.923) and 0.738 (95 % CI, 0.608-0.834), respectively. The AUCs of BE and SE models were 0.927 (95 % CI, 0.829-0.978) and 0.874 (95 % CI, 0.763-0.946), respectively. The AUC, sensitivity, specificity, and accuracy of the derived four values (ADC, D, f, and DDC) from the combination of three models were 0.950, 96.6 % (95 % CI, 95.3-97.6 %), 80.6 % (95 % CI, 78.0-82.9 %), and 88.3 % (95 % CI, 86.2-90.2 %), respectively.
CONCLUSION
ADC can easily and effectively predict rectal adenomas with canceration. The BE model has a better combination of sensitivity and specificity for the diagnosis of rectal adenoma canceration.
目的
评估单指数（ME）、双指数（BE）和拉伸指数（SE）模型下的体素内不相干运动（IVIM）扩散加权成像（DWI）在预测伴有癌变的直肠腺瘤中的临床价值。
材料与方法
纳入 60 名经术后病理证实的直肠腺瘤患者（n=31）和伴有癌变的腺瘤患者（n=29），并进行 IVIM-DWI 扫描。测量 ME 衍生的表观扩散系数（ADC）、BE 衍生的真实扩散系数（D）、假性扩散系数（D*）、灌注分数（f）、SE 衍生的分布扩散系数（DDC）和水分子扩散异质性指数（α）。比较腺瘤和癌变之间各参数的差异。采用多变量二元逻辑回归分析建立预测伴有癌变的直肠腺瘤的模型。应用受试者工作特征曲线分析评估各模型在敏感性、特异性、准确性和曲线下面积（AUC）方面的诊断性能。
结果
ADC、D、D*、f、DDC 和 α 的 AUC 值分别为 0.851（95%置信区间，0.735-0.930）、0.895（95%置信区间，0.789-0.960）、0.720（95%置信区间，0.589-0.828）、0.791（95%置信区间，0.667-0.886）、0.841（95%置信区间，0.724-0.923）和 0.738（95%置信区间，0.608-0.834）。BE 和 SE 模型的 AUC 值分别为 0.927（95%置信区间，0.829-0.978）和 0.874（95%置信区间，0.763-0.946）。来自三个模型组合的四个值（ADC、D、f 和 DDC）的 AUC、敏感性、特异性和准确性分别为 0.950、96.6%（95%置信区间，95.3-97.6%）、80.6%（95%置信区间，78.0-82.9%）和 88.3%（95%置信区间，86.2-90.2%）。
结论
ADC 可有效预测伴有癌变的直肠腺瘤。BE 模型在诊断直肠腺瘤癌变时具有更好的敏感性和特异性组合。
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