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目的探讨多b值双指数模型DWI对食管癌的诊断价值。方法 35例经病理证实的食管癌患者纳入研究,所有患者均行多b值DWI检查(11个b值:0、10、20、30、50、100、200、400、800、1200、1500 s/mm~2)。获得双指数模型参数:标准表观扩散系数(ADC_(st))、慢速表观扩散系数(ADC_(slow))、快速表观扩散系数(ADC_(fast))、快速扩散成分所占比例(F_(fast))。绘制ROC曲线,比较各参数对食管癌病变与正常食管管壁的诊断效能。结果病变组的ADC_(slow)、ADC_(fast)、ADC_(st)、F_(fast)值分别为(1.18±0.18)×10~(-3)mm~2/s、(10.63±4.87)×10~(-3)mm~2/s、(2.30±0.46)×10~(-3)mm~2/s、0.42±0.15;正常组的ADC_(slow)、ADC_(fast)、ADC_(st)、F_(fast)值分别为(1.24±0.25)×10~(-3)mm~2/s、(10.36±3.71)×10~(-3)mm~2/s、(2.88±0.57)×10~(-3)mm~2/s、0.59±0.12。两组间F_(fast)值差异具有统计学意义。ROC曲线分析发现F_(fast)值鉴别两者的最佳诊断界点为0.47,敏感性为88.1%,特异性为56.9%,曲线下面积为0.784。结论多b值双指数衰减模型能够有效评价食管癌血流灌注与扩散变化信息,F值对食管癌的诊断效能较高。
Objective To investigate the diagnostic value of multi-b value double exponential model DWI for esophageal cancer. Methods 35 patients with pathologically confirmed esophageal cancer were included in the study. All patients underwent multi-b DWI (11 b values: 0, 10, 20, 30, 50, 100, 200, 400, 800, 1200, 1500 s / mm ~ 2). The parameters of double exponential model were obtained: standard apparent diffusion coefficient (ADC st), slow apparent diffusion coefficient (ADC slow), fast apparent diffusion coefficient (ADC fast) F fast). ROC curve was drawn and the diagnostic efficacy of each parameter on esophageal cancer lesions and normal esophageal wall was compared. Results The ADC_ (fast), ADC_ (st), F fast values of the lesion group were (1.18 ± 0.18) × 10 -3 mm 2 / s, (10.63 ± 4.87) × The ADC_ (fast), ADC_ (st) of normal group were higher than that of normal group (P <0.05) ), F fast values were (1.24 ± 0.25) × 10 -3 mm 2 / s, (10.36 ± 3.71) × 10 -3 mm 2 / s and (2.88 ± 0.57) × 10 ~ (-3) mm ~ 2 / s, 0.59 ± 0.12. F_ (fast) value difference between the two groups was statistically significant. ROC curve analysis showed that the best diagnostic cutoff point of F fast was 0.47, the sensitivity was 88.1%, the specificity was 56.9% and the area under the curve was 0.784. Conclusions The multi-b value double exponential decay model can effectively evaluate the changes of perfusion and diffusion in esophageal cancer, and the F value has a high diagnostic value for esophageal cancer.