Chen Hao, Jin Zhicheng, Dai Xiaoxiao, Zhu Juan, Chen Guangqiang
Department of Medical Imaging, Anqing Municipal Hospital, Anqing, China.
Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Heliyon. 2024 Sep 5;10(18):e37526. doi: 10.1016/j.heliyon.2024.e37526. eCollection 2024 Sep 30.
To compare the diagnostic value of histogram analysis derived from diffusion weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in differentiating the mismatch repair (MMR) status of rectal adenocarcinoma.
DWI and DKI were performed in 124 patients with rectal adenocarcinoma, which were divided into deficient mismatch repair (dMMR) group and proficient mismatch repair (pMMR) group. The patients' general clinical information, pathology and image characteristics were compared. The histogram analysis of apparent diffusion coefficient (ADC), diffusion kurtosis (K) and diffusion coefficient (D)derived from DWI and DKI at b values of 1000 and 2000 s/mm were calculated. The diagnostic efficacy of quantitative parameters for MMR in rectal adenocarcinoma was compared.
The mean, 50th, 75th and 90th in ADC quantitative parameters of dMMR group were lower when the b value was 2000 s/mm (all < 0.05). With b value of 1000 s/mm, the 10th, 25th, and 50th in the dMMR group were lower, and the skewness was higher (all < 0.05). D values (10th, 25th and 50th) derived from DKI quantitative parameters were lower in the dMMR group. The K values (75th, 90th and Kskewness) were higher in the dMMR group, while Kkurtosis was lower (all < 0.05). The results of multivariate logistic regression analysis showed that ADC75th(b = 2000 s/mm), ADCskewness (b = 1000 s/mm) and Kskewness were the statistical significant parameters ( = 0.014, 0.036 and 0.002, respectively), and the AUC values were 0.713, 0.818 and 0.835, respectively.
Histogram analysis derived from DWI and DKI can be good predictor of MMR. Kskewness is the strongest independent factor for predicting MMR.
比较扩散加权成像（DWI）和扩散峰度成像（DKI）直方图分析在鉴别直肠腺癌错配修复（MMR）状态中的诊断价值。
对124例直肠腺癌患者进行DWI和DKI检查，将患者分为错配修复缺陷（dMMR）组和错配修复正常（pMMR）组。比较患者的一般临床信息、病理及影像特征。计算b值为1000和2000 s/mm时，DWI和DKI得出的表观扩散系数（ADC）、扩散峰度（K）和扩散系数（D）的直方图分析结果。比较直肠腺癌MMR定量参数的诊断效能。
当b值为2000 s/mm时，dMMR组ADC定量参数的均值、第50、75和90百分位数均较低（均P<0.05）。当b值为1000 s/mm时，dMMR组的第10、25和50百分位数较低，偏度较高（均P<0.05）。DKI定量参数得出的D值（第10、25和50百分位数）在dMMR组较低。dMMR组的K值（第75、90百分位数和K偏度）较高，而K峰度较低（均P<0.05）。多因素logistic回归分析结果显示，ADC第75百分位数（b=2000 s/mm）、ADC偏度（b=1000 s/mm）和K偏度是具有统计学意义的参数（分别为P=0.014、0.036和0.002），曲线下面积（AUC）值分别为0.713、0.818和0.835。
DWI和DKI的直方图分析可作为MMR的良好预测指标。K偏度是预测MMR的最强独立因素。
