动态增强MRI微血管通透性参数与Ⅱ期宫颈癌复发的相关性研究

摘要

Objective:To study the correlation between microvascular permeability parameters of 4D T1 high resolu-tion isotropic volume excitation (THRIVE)dynamic contrast-enhanced MRI and recurrence of cervical carcinoma stage Ⅱ. Methods:Fifty-six patients with cervical carcinoma stage Ⅱ (including 1 7 patients with recurrent cervical carcinoma and 3 9 patients with without cervical carcinoma recurrence)underwent rountine MRI and 4D-THRIVE dynamic contrast-enhanced MR scan.Microvascular permeability parameters Ktrans ,Kep and Ve values were obtained through fitting non-linear models of the region of interest STC and CTC under Matlab flatform,and were analysed in patients with recurrence group and no re-currence group.Results:The recurrene group had significantly higher levels of Ktrans and Kep than the no recurrence group (P<0.05).The diagnostic value of Ktrans was better than Kep ,the area under the curve was 0.92.When Ktrans≥0.73min-1 , the sensitivity and specificity for diagnosing recurrence of cervical carcinoma stage Ⅱ were 88.2% and 79.5%.Conclusion:Ktrans as microvascular permeability characteristics parameters could be a predictor of recurrence of cervical carcinoma and be useful for guiding treatment.%目的：探讨磁共振四维高分辨率各向同性容积激发（4D-THRIVE）序列动态增强扫描定量分析Ⅱ期复发宫颈癌微血管通透性参数的特点及临床意义。方法：回顾性分析56例Ⅱ期宫颈癌患者（宫颈癌复发17例，无复发39例）术前常规MRI及4D-THRIVE动态增强扫描资料，在Matlab平台下对兴趣区时间-信号强度曲线（STC）及时间-平均对比剂浓度曲线（CTC）进行非线性拟合，获得血管通透性参数（Ktrans、Kep及Ve ）值，评估宫颈癌复发组和无复发组血管通透性的特点。结果：宫颈癌复发组较无复发组的Ktrans及Kep值显著升高（P＜0．05），以Ktrans的诊断效能最佳，曲线下面积AUC＝0．92，当Ktrans≥0．73min－1时，其诊断Ⅱ期复发宫颈癌的敏感度为88．2％，特异度为79．5％。结论：复发宫颈癌的微血管通透性指标Ktrans显著升高，并且具有较高的诊断效能，可作为术前指导临床个体化综合治疗方案以及评估预后的参考依据。