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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (02) : 132 -138. doi: 10.3877/cma.j.issn.2095-3224.2023.02.007

论著

高分辨弥散加权成像ADC直方图参数与直肠癌临床特征相关性的回顾性研究
王欣1, 孙丹琦1, 黄瑾瑜1,()   
  1. 1. 215000 苏州大学附属第一医院放射科
  • 收稿日期:2022-08-24 出版日期:2023-04-25
  • 通信作者: 黄瑾瑜
  • 基金资助:
    苏州市“科教兴卫”青年科技项目(KJXW2020010); 江苏省苏州市民生科技项目(SYS201734)

Correlation of ADC histogram parameters from high-resolution diffusion-weighted imaging with clinical characteristics in rectal cancer: a retrospective study

Xin Wang1, Danqi Sun1, Jinyu Huang1,()   

  1. 1. Department of Radiology, the First Affiliated Hospital of Soochow Uniiversity, Suzhou 215000, China
  • Received:2022-08-24 Published:2023-04-25
  • Corresponding author: Jinyu Huang
引用本文:

王欣, 孙丹琦, 黄瑾瑜. 高分辨弥散加权成像ADC直方图参数与直肠癌临床特征相关性的回顾性研究[J/OL]. 中华结直肠疾病电子杂志, 2023, 12(02): 132-138.

Xin Wang, Danqi Sun, Jinyu Huang. Correlation of ADC histogram parameters from high-resolution diffusion-weighted imaging with clinical characteristics in rectal cancer: a retrospective study[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(02): 132-138.

目的

为了阐明高分辨弥散加权成像ADC的直方图参数与直肠癌临床特征的相关性。

方法

回顾性分析研究46例直肠癌患者术前高分辨弥散加权图像以及术后病理样本。采用开源软件MaZda对所有受试者的高分辨ADC图像进行特征提取,并进行直方图分析,根据肿瘤分级、T/N分期、血浆癌胚抗原(CEA)水平对患者进行分组,评估各临床特征与ADC直方图参数之间的相关性。

结果

经病理证实的直肠癌患者,Spearman相关性分析显示,T分期越低的肿瘤,ADC直方图参数的Perc 1%越低(r=0.358,P=0.015)。ADC直方图参数在肿瘤分化程度、N分期及血浆CEA水平间差异无统计学意义(P<0.05)。

结论

术前ADC直方图参数Perc 1%和肿瘤T分期之间存在显著正相关性。由高分辨弥散加权图像获得的ADC直方图参数可用于评估直肠癌的病理分期。

Objective

To elucidate the possible associations between ADC histogram parameters obtained using readout-segmented echo-planar imaging (rs-EPI; RESOLVE) diffusion-weighted magnetic resonance imaging (DW-MRI) and several clinical features in rectal cancer (RC).

Methods

This retrospective study was performed by screening RESOLVE DWI and postoperative pathological samples of 46 patients with rectal cancer. ADC histogram analysis was performed on the RESOLVE ADC maps. The patients were grouped according to cancer grade,TN stage,and the plasma carcinoembryonic antigen (CEA) level. The correlations between each clinical feature and ADC histogram parameters were evaluated using open source software MaZda.

Results

A total of 46 patients with pathologically confirmed RC were enrolled. Spearman's correlation analysis revealed that tumors with a lower T stage corresponded to lower Perc 1% values (r=0.358, P=0.015). Nevertheless,there were no significant differences in ADC parameters between tumor differentiation grade,N stage,and plasma CEA level (all P>0.05).

Conclusion

Our study revealed a significant correlation between the tumor T stage and preoperative Perc 1% ADC parameters alluding to a potential relationship between different pathologically confirmed T stages and histogram results. These findings suggest that ADC parameters derived from RESOLVE images may be used to assess the biological behaviors of RC.

图1 纳入与排除病例流程图
图2 RESOLVE ADC图中提取直方图特征的热图
表1 ADC直方图参数及组内观察者一致性分析
图3 同一例RC患者的高分辨率和传统DW图像和ADC图。3A:高分辨DW图像;3B:高分辨ADC图像;3C:传统DW图像;3D:传统ADC图像。肿瘤的ADC值分别为0.89(3A,3B)和0.96(3C,3D)
图4 通过rs-EPI获得肿瘤不同T分期的ADC图。4A:T1期直肠癌;4B:T2期直肠癌;4C:T3期直肠癌;4D:T4期直肠癌。4A~4D肿瘤ADC值分别为0.75、0.85、0.73和0.69
图5 通过rs-EPI获得不同分化等级肿瘤的ADC图及相应的HE染色组织病理学图像。5A~5C的ADC值分别为0.55、0.73和0.89
图6 ADC直方图参数与直肠癌临床病理特征的相关性分析。*P<0.05(双检验),差异有统计学意义;**P<0.01(双重检验),差异有统计学意义
图7 通过rs-EPI获得低/高血浆CEA水平肿瘤相应ADC图。7A:血浆CEA低水平肿瘤;7B:血浆CEA高水平肿瘤。7A~7B的ADC值分别为0.89和0.96
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