目的:评估体素内不相干运动(IVIM)DWI对胰腺导管腺癌(PDAC)的转移性和非转移性淋巴结站(LNS)的诊断潜力。
方法:纳入了15例手术切除后经组织学诊断的59例LNS患者。将具有12b值的IVIMDWI添加到标准MRI方案中。术前进行参数评估,包括表观扩散系数(ADC),纯扩散系数(D),伪扩散系数(D*)和灌注分数(f)。ADC的诊断性能,D,使用ROC分析评估用于区分转移性和非转移性LNS的D*和f。
结果:转移性LNS的D,D*,f和ADC值高于非转移性LNS(p<0.01)。在D中发现了最好的诊断性能,ROC曲线下面积为0.979,而ROC曲线下面积为D*,f和ADC分别为0.867、0.855和0.940。区分转移性和非转移性淋巴结的最佳临界值为D=1.180×10-3mm2/s;D*=14.750×10-3mm2/s,f=20.65%,ADC=1.390×10-3mm2/s。
结论:IVIMDWI可用于区分PDAC中的转移性和非转移性LNS。
结论:•IVIMDWI诊断PDAC中LN转移是可行的。•转移性LNS具有较低的D,D*,f,ADC值比非转移性LNS。•IVIM模型的D值具有最佳诊断性能,其次是ADC值。•D*具有最低AUC值。
OBJECTIVE: To evaluate the diagnostic potential of intravoxel incoherent motion (IVIM) DWI for differentiating metastatic and non-metastatic lymph node stations (LNS) in pancreatic ductal adenocarcinoma (PDAC).
METHODS: 59 LNS histologically diagnosed following surgical resection from 15 patients were included. IVIM DWI with 12 b values was added to the standard MRI protocol. Evaluation of parameters was performed pre-operatively and included the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f). Diagnostic performance of ADC, D, D* and f for differentiating between metastatic and non-metastatic LNS was evaluated using ROC analysis.
RESULTS: Metastatic LNS had significantly lower D, D*, f and ADC values than the non-metastatic LNS (p< 0.01). The best diagnostic performance was found in D, with an area under the ROC curve of 0.979, while the area under the ROC curve values of D*, f and ADC were 0.867, 0.855 and 0.940, respectively. The optimal cut-off values for distinguishing metastatic and non-metastatic lymph nodes were D = 1.180 × 10-3 mm2/s; D* = 14.750 × 10-3 mm2/s, f = 20.65 %, and ADC = 1.390 × 10-3 mm2/s.
CONCLUSIONS: IVIM DWI is useful for differentiating between metastatic and non-metastatic LNS in PDAC.
CONCLUSIONS: • IVIM DWI is feasible for diagnosing LN metastasis in PDAC. • Metastatic LNS has lower D, D*, f, ADC values than non-metastatic LNS. • D-value from IVIM model has best diagnostic performance, followed by ADC value. • D* has the lowest AUC value.