| 秦晓峰,王丹丹,李海学,等.胃磁共振成像动态对比增强扫描血流动力学参数与局部进展期胃癌病理分级的相关性研究[J].安徽医药,2025,29(11):2299-2303. |
| 胃磁共振成像动态对比增强扫描血流动力学参数与局部进展期胃癌病理分级的相关性研究 |
| Correlation between hemodynamic parameters of stomach dynamic contrast-enhanced magnetic resonance imaging and pathological grading in locally advanced gastric cancer |
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| DOI：10.3969/j.issn.1009-6469.2025.11.039 |
| 中文关键词: 胃肿瘤 腹部磁共振增强扫描 血流动力学 肿瘤分期 病理分级 (6，致性， |
| 英文关键词: Stomach neoplasms Abdomen dynamic contrast-enhanced magnetic resonance scan Hemodynamics Neoplasm staging Pathological grading |
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| 中文摘要: |
| 目的探讨胃磁共振成像动态对比增强扫描( DCE-MRI)血流动力学参数与局部进展期胃癌病理分级的相关性。方法回顾性分析 2019年 1月至 2022年 12月晋城大医院接收的 156例局部进展期胃癌和 150例胃部良性病变病人的临床资料。所有病人均行胃 DCE-MRI检查，记录血流动力学参数［容积转运常数( Ktrans)、速率常数( Kep)、血管外细胞外间隙容积分数(Ve)］。比较进展期胃癌和胃部良性病变病人的 DCE-MRI血流动力学参数。根据手术病理组织检查结果将所有病人分为低未 /中/高分化组(66/75/15例)，比较不同病理分级的 DCE-MRI血流动力学参数。采用受试者操作特征曲线(ROC曲线)分析 DCE-MRI血流动力学参数对局部进展期胃癌中高分化和低未分化的诊断价值。结果局部进展期胃癌 Ktrans［0.18(0.15，0.21)/min］、 Kep［0.43(0.35，0.51)/min］、 (0.35±0.09)均高于良性病变［0.12(0.11，0.14)/min、0.33(0.25，0.38)/min、0.28±0.07］(P<0.05)；低未分化组 Ktrans［、［Ve0.46)(0.17±0.04)/min、Ve(0.22±0.04)/min］Kep(0.49±0.10)/min］［0.38(0.28， ］均高于中高分化组［(0.40±0.09)/min、0.33(0.23，0.38)］)；［( 0.20±0.05min］、 Kep(0.37±0.09)高于鳞癌［( 0.15±0.04)/min、)/、(P<0.05腺癌 Ktrans［( 0.46±0.11)/min］、 Ve(0.33±0.09)/min、0.27±0.07］、印戒细胞癌［( 0.15±0.04)/min、(0.32±0.09)/min、0.26±0.07］和未分化癌［( 0.11±0.04)/min、(0.33±0.08)/min、0.24±0.07］(P<0.05)； ROC曲线分析结果显示， Ktrans、Kep、Ve联合诊断局部进展期胃癌低未分化的灵敏度( 95.45%)和曲线下面积(AUC)(0.92)均高于各指标单独诊断( 84.85%、81.82%、53.03%和 0.79、0.78、0.71)(P<0.05)，联合特异度(85.56%)均高于 Ktrans、Kep单独诊断1.11%、60.00%)；以手术病理结果为“金标准”经 Kappa一致性检验发现， DCE-MRI血流动力学参数对局部进展期胃癌不同病理分级的诊断结果与手术病理检查结果一为 0.79。结论 DCE-MRI血流动力学参数 Ktrans、 Kep、Ve均对局部进展期胃癌的病理分级具有一定的诊断价值，但三项参数联合可提高其诊断效能，与病理分级结果一致性良好，对临床判断胃癌分化程度具有较好的辅助指导作用。 |
| 英文摘要: |
| Objective To investigate the correlation between hemodynamic parameters derived from stomach dynamic contrast-en-hanced magnetic resonance imaging (DCE-MRI) and pathological grading in locally advanced gastric cancerMethods Clinical data of 156 patients with locally advanced gastric cancer and 150 patients with benign gastric lesions admitted to Jincheng General Hospitalfrom January 2019 to December 2022 were retrospectively analyzed. All patients underwent stomach DCE-MRI, and following hemody-namic parameters were recorded: volume transport constant (Ktrans), rate constant (Kep) and extracellular extravascular space volume frac-tion (Ve)]. DCE-MRI hemodynamic parameters were compared between patients with advanced gastric cancer and those with benign gas-tric lesions. Based on surgical pathology findings, patients were divided into poorly differentiated/undifferentiated (66 cases), moderate-ly differentiated (75 cases), and well-differentiated (15 cases) groups. DCE-MRI hemodynamic parameters were compared across thesepathological grades. Receiver operating characteristic curve (ROC curve) analysis was used to evaluate the diagnostic value of DCE-MRI hemodynamic parameters for distinguishing between moderately/well-differentiated and poorly differentiated/undifferentiated lo-cally advanced gastric cancer.Results Ktrans [0.18(0.15, 0.21)/min], Kep [0.43(0.35, 0.51)/min] and Ve (0.35±0.09) values were signifi-cantly higher in locally advanced gastric cancer compared to benign lesions [0.12(0.11, 0.14)/min, 0.33(0.25, 0.38)/min, 0.28±0.07] (P< 0.05). The poorly differentiated/undifferentiated group showed significantly higher Ktrans [(0.22±0.04)/min], Kep [(0.49±0.10)/min], and Ve [0.38(0.28, 0.46)] values than the moderately/well-differentiated group [(0.17±0.04)/min, (0.40±0.09)/min, 0.33(0.23, 0.38)] (P<0.05). Adenocarcinoma demonstrated significantly higher Ktrans [(0.20±0.05)/min], Kep [(0.46±0.11)/min] and Ve (0.37±0.09) values compared to |
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