术前预测 T3 期可切除胆囊癌肝侵犯的扩散加权成像表观扩散系数及其标准差。
Apparent diffusion coefficient and its standard deviation from diffusion-weighted imaging in preoperative predicting liver invasion by T3-staged resectable gallbladder carcinoma.
机构信息
Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Department of Radiology, Meishan Hospital of Traditional Chinese Medicine, Meishan, Sichuan, China.
Medical Imaging Key Laboratory of Sichuan Province, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, China.
出版信息
Clin Radiol. 2024 Feb;79(2):e247-e255. doi: 10.1016/j.crad.2023.10.033. Epub 2023 Nov 16.
AIM
To evaluate apparent diffusion coefficient (ADC) and its standard deviation (SD) in preoperative predicting liver invasion by T3-staged gallbladder carcinoma (GBC).
MATERIALS AND METHODS
Forty-one consecutive patients with T3-staged resectable GBC were included and divided into two sets with (n=27) and without (n=14) liver invasion. All patients underwent DWI at b-values of 0, 20, 50, 80, 100, 200, 400, 600, 800, and 1,000 s/mm with a 3 T magnetic resonance imaging scanner before surgery. ADC and SD of tumour-adjacent and tumour-distant liver tissues were measured on DWI, and were compared by Mann-Whitney U-tests. If there was a significant difference in any derived parameter, the area under the receiver operating characteristic curve (AUC) was used to assess performance of this parameter to predict liver invasion.
RESULTS
DWI could differentiate between patients with and without liver invasion when b = 0, 1,000 s/mm (AUCs of ADC and SD were 0.697 and 0.714, respectively). In patients with liver invasion, mean ADC and SD of tumour-adjacent liver tissue were lower than of tumour-distant liver tissue when b = 0, 800 s/mm, and = 0, 1,000 s/mm (all p-values <0.05). To differentiate tumour-adjacent from tumour-distant liver tissues in patients with liver invasion, AUCs of ADC were 0.687 (b = 0, 800 s/mm) and 0.680 (b = 0, 1,000 s/mm), and AUCs of SD were 0.673 (b = 0, 800 s/mm) and 0.731 (b = 0, 1,000 s/mm).
CONCLUSIONS
DWI could have potential value in preoperative predicting liver invasion by T3-staged GBC.
目的
评估 T3 期胆囊癌（GBC）术前 ADC 值及其标准差（SD）在预测肝侵犯中的作用。
材料与方法
共纳入 41 例 T3 期可切除 GBC 患者，分为有（n=27）和无（n=14）肝侵犯两组。所有患者术前均在 3.0T 磁共振成像扫描仪上进行 DWI，b 值分别为 0、20、50、80、100、200、400、600、800 和 1000 s/mm。在 DWI 上测量肿瘤旁和肿瘤远隔肝组织的 ADC 和 SD，并采用 Mann-Whitney U 检验进行比较。如果任何衍生参数存在显著差异，则使用受试者工作特征曲线（ROC）下面积（AUC）评估该参数预测肝侵犯的性能。
结果
当 b=0、1000 s/mm 时，DWI 可区分有和无肝侵犯的患者（ADC 和 SD 的 AUC 分别为 0.697 和 0.714）。在有肝侵犯的患者中，当 b=0、800 s/mm 及 b=0、1000 s/mm 时，肿瘤旁肝组织的平均 ADC 和 SD 均低于肿瘤远隔肝组织（均 p<0.05）。为了区分有肝侵犯患者的肿瘤旁和肿瘤远隔肝组织，ADC 的 AUC 分别为 0.687（b=0、800 s/mm）和 0.680（b=0、1000 s/mm），SD 的 AUC 分别为 0.673（b=0、800 s/mm）和 0.731（b=0、1000 s/mm）。
结论
DWI 术前预测 T3 期 GBC 肝侵犯可能具有一定价值。
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