基于单指数、峰度与拉伸指数扩散成像模型的磁共振检查在预测前列腺癌分级中的价值研究
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东南大学附属中大医院

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Value of MRI Based on Single Exponential, Kurtosis and Stretched Exponential Diffusion Imaging Models in Predicting the Grade of Prostate Cancer
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    摘要:

    目的 将前列腺MRI中DWI数据通过计算得到DKI和SEM模型各参数,并与术后病理结果中的预后分组进行回归分析,评价各参数与预后分组的相关性,从而评估上述模型各参数对于区分前列腺癌恶性程度、预测病理学分级的价值。方法 回顾性收集经手术病理证实为前列腺癌的病例71例,对其术前进行的MRI扫描中的DWI进行重建,获得DKI的参数:平均峰度(mean kurtosis,MK)、平均扩散系数(mean diffusivity,MD),和SEM的参数:扩散分布指数(distributed diffusion coefficient,DDC)、扩散异质性指数(α),表观扩散系数(apparent diffusion coefficient,ADC)由扫描系统自动生成;由两位医师在各参数图上根据病理学提示勾画ROI并进行数据统计,通过Cronbach′s Alpha检验可信任度后,使用Kruskal-Wallis检验对相邻预后分组之间的各项参数分布进行比较;将ADC分别与DDC、MD进行Wilcoxon秩检验;对各参数与预后分组之间的相关性使用Spearman相关性分析,以相关系数r的大小评价相关性强弱;对各项参数和预后分组间的关系进行曲线拟合,以R2的大小评价拟合度高低。结果 两位医师的评分数据Cronbach′s Alpha系数为0.910;ADC、α、DDC、MD、MK在各预后分组上的分布均存在差异(均有P<0.05);ADC与DDC的分布有显著差异(P<0.01),ADC与MD的分布差异无统计学意义(P>0.05);ADC、DDC、MD与预后分组均呈负相关,r值分别为-0.601、-0.627、-0.566,且以逆模型的拟合度较高,R2分别为0.644、0.749、0.643;MK与预后分组呈正相关,r=0.537,逆模型的R2为0.345;α与预后分组的相关性、曲线拟合度较低,r=0.239。结论 前列腺癌预后分组的预判中,单指数模型仍是实际应用中性价比最高的方法,SEM中的DDC有比ADC更优秀的表现,DKI中的MD和ADC表现相当。

    Abstract:

    Objective To calculate the DWI data of prostate MRI to obtain the parameters of DKI and SEM model, and conduct regression analysis with the prognostic grouping in the postoperative pathological results, so as to evaluate the correlation between the parameters and the prognostic grouping, so as to evaluate the value of the parameters of the above model in distinguishing the malignant degree of prostate cancer and predicting the pathological grade. Methods 71 cases of prostate cancer confirmed by pathology were collected retrospectively. The DWI in MRI scan before surgery was reconstructed to obtain MK and MD of DKI,DDC and α of SEM.ADC was automatically generated by the scanning system; Two doctors outlined ROI on each parameter map according to pathological tips,and made data statistics. After the reliability was tested by Cronbach's alpha, the distribution of parameters between adjacent prognostic groups was compared by Kruskal Wallis test; Wilcoxon rank test was performed on ADC, DDC and MD respectively; Spearman correlation analysis was used to evaluate the correlation between various parameters and prognosis groups; The relationship between various parameters and prognosis groups was curve fitted, and the fitting degree was evaluated by the size of R2. Results Cronbach's alpha coefficient of the score data of the two doctors was 0.910; There were differences in the distribution of ADC,α,DDC,MD and MK in each prognostic group (all P<0.05); there was significant difference in the distribution of ADC and DDC (P<0.01), and there was no significant difference in the distribution of ADC and MD (P>0.05); ADC, DDC and MD were negatively correlated with prognosis, r values were -0.601, -0.627 and -0.566 respectively, and the fitting degree of inverse model was high, R2 were 0.644, 0.749 and 0.643 respectively; MK was positively correlated with prognosis, r=0.537 and R2 of inverse model was 0.345; The correlation and curve fitting between α and prognosis were low, r=0.239. Conclusions In the prediction of prognosis grouping of prostate cancer, the single exponential model is still the most cost-effective method in practical application. DDC in the SEM has better performance than ADC, and MD in the DKI have the same performance with ADC.

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  • 收稿日期:2022-05-10
  • 最后修改日期:2022-06-02
  • 录用日期:2022-08-11
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