动态增强MRI成像参数对非小细胞肺癌淋巴结转移的评估作用

Evaluation of dynamic contrast-enhanced MRI parameters for lymph node metastasis in non-small cell lung cancer

摘要:

目的 分析动态增强磁共振成像（DCE-MRI）参数对非小细胞肺癌（NSCLC）患者淋巴结转移的评估作用。方法 选取2019年3月至2022年3月郑州大学第二附属医院收治的143例NSCLC患者为研究对象，所有患者均行手术切除治疗，术后对切除的淋巴结进行病理检查，根据病理检查结果将患者分为淋巴结转移组和和无淋巴结转移组。所有患者在术前进行DCE-MRI扫描，根据时间-信号强度曲线计算NSCLC患者DCE-MRI参数［最大增强线性斜率（SS）、容积转移常数（K_trans）、血管外细胞外容积参数（V_e）、运动速率常数（K_ep）］。比较两组DCE-MRI参数（SS、K_trans、V_e、K_ep）水平，并分析DCE-MRI参数对NSCLC患者发生淋巴结转移的评估作用。结果 淋巴结转移组腺癌、肿瘤直径≥5 cm、低分化占比高于无淋巴结转移组（P<0.05）。淋巴结转移组患者SS、K_trans、V_e、K_ep水平高于无淋巴结转移组（P<0.05）。腺癌、SS、K_trans、V_e、K_ep水平均是影响NSCLC患者发生淋巴结转移的危险因素（P<0.05）。SS、K_trans、V_e、K_ep水平联合预测NSCLC患者发生淋巴结转移的灵敏度、曲线下面积（AUC）分别为96.03%、0.848，均高于各指标单独预测（P<0.05）。结论 SS、K_trans、V_e、K_ep水平在NSCLC患者中水平异常升高，且均是影响NSCLC患者发生淋巴结转移的危险因素，对患者淋巴结转移具有一定的预测价值，且联合检测的价值更高。

关键词:动态增强磁共振成像;非小细胞肺癌;淋巴结转移;成像参数

Abstract:

Objective To analyze the effect of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters on the assessment of lymph node metastasis in patients with non-small cell lung cancer (NSCLC).Methods A total of 143 patients with NSCLC who were treated in the Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2022 were selected as the research objects. All patients underwent surgical resection. The resected lymph nodes were subjected to pathological examination after operation. According to the results of the pathological examination, the patients were divided into lymph node metastasis group and non-lymph node metastasis group. All patients underwent DCE-MRI scans before surgery, and the DCE-MRI parameters of NSCLC patients were calculated according to the time-signal intensity curve [the steepest slope (SS), volume transfer constant (Ktrans), extravascular and extracellular volume parameters (Ve), movement rate constant (Kep)]. The levels of DCE-MRI parameters (SS, Ktrans, Ve, Kep) were compared between the two groups, and the effect of DCE-MRI parameters on the assessment of lymph node metastasis in NSCLC patients was analyzed.Results The proportion of adenocarcinoma, tumor diameter ≥5 cm, and poor differentiation in the lymph node metastasis group was higher than that in the non-lymph node metastasis group (P<0.05). The levels of SS, Ktrans, Ve, and Kep in the lymph node metastasis group were higher than those in the non-lymph node metastasis group (P<0.05). Adenocarcinoma, SS, Ktrans, Ve, and Kep levels were all risk factors for lymph node metastasis in NSCLC patients (P<0.05). The combined sensitivity and AUC of SS, Ktrans, Ve, and Kep levels in predicting lymph node metastasis in NSCLC patients were 96.03% and 0.848, respectively, which were higher than the individual predictions of each index (P<0.05).Conclusion The levels of SS, Ktrans, Ve, and Kep are abnormally elevated in NSCLC patients, and they are all risk factors for lymph node metastasis in NSCLC patients.

Key words:dynamic contrast-enhanced magnetic resonance imaging;non-small cell lung cancer;lymph node metastasis;imaging parameters