目的：探讨基于肿瘤全域的表观扩散系数（Apparent diffusion coefficient，ADC）纹理分析对上皮性卵巢癌（Epithelial ovarian carcinoma，EOC）复发的预测价值。方法：回顾性分析49例经病理证实为EOC患者的术前DWI成像（b=0、800 s/mm2），利用后处理软件在ADC图上绘制全瘤的感兴趣区，分析提取出纹理参数，包括偏度、峰度、熵值、惰性、相关性、对比度、变异等共77个参数。采用多因素Logistic回归分析确定可作为复发的最佳预测因素，绘制ROC曲线评价其预测效能。结果：两组患者肿瘤大小及腹水复发组均高于非复发组，差异有统计学意义（P<0.05），FIGO分期两组间差异有统计学意义（P<0.05）。复发组惰性、对比度、变异、熵值显著高于非复发组，峰度、第10百分位数、第25百分位数、相关性显著低于非复发组，差异均有统计学意义（P<0.05）。ROC曲线分析显示峰度、惰性、相关性、肿瘤大小、FIGO分期联合预测复发的曲线下面积最大，为0.929。结论：基于全肿瘤容积的ADC纹理分析有助于预测EOC患者复发。
Abstract
Objective: To investigate the recurrence prediction value of apparent diffusion coefficient(ADC) based on whole tumor volume measurement in patients with epithelial ovarian cancer(EOC). Methods: A retrospective analysis of 49 patients with pathologically proven EOC who underwent preoperative DWI imaging(b=0, 800 s/mm2) was carried out. The post-processing software was used to map the region of interest of the whole tumor on the ADC map, and the texture parameters such as skewness, kurtosis, entropy, inertia, correlation, contrast, variance were extracted and analyzed. Multivariate Logistic regression analysis was used to determine the best predictor of recurrence, and the predictive efficiency of the relevant parameters for recurrence after surgery was evaluated by receiver operating characteristic curve. Results: Tumor size and ascites were higher in recurrence group than those in non-recurrent group. The differences were statistically significant(P<0.05). The difference between the two groups in FIGO staging was statistically significant. The parameters of texture analysis, including inertia, contrast, variance and entropy in recurrence group were higher than those in non-recurrent group. Kurtosis, quantile 10, quantile 25 and correlation in recurrence group were lower than those in non-recurrent group. The differences were statistically significant(P<0.05). ROC curve analysis showed that the area under the curve of kurtosis, inertia, correlation, tumor size and FIGO stage combined to prediction recurrence was the highest, 0.929. Conclusion: The preoperative texture analysis of ADC images based on total tumor volume helps predicting recurrence of EOC.
关键词
卵巢肿瘤 /
磁共振成像
Key words
Ovarian neoplasms /
Magnetic resonance imaging
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基金
南通市卫生健康委员会科研立项课题（QA2019031）。
