初探扩散峰度成像多定量参数评估子宫内膜癌Ki-67表达的价值

doi:10.12117/jccmi.2018.11.010

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Abstract Objective: To investigate the correlation between multiple quantitative parameters of diffusion kurtosis imaging sequence and the expression of proliferating antigen Ki-67 in endometrial carcinoma(EC). Methods: We retrospectively analyzed 21 cases of imaging data with 1.5T MRI examination(including DKI sequence) diagnosed as EC. The index of immunohistochemical analysis included Ki-67. According to the Ki-67 expression index(<50% was low expression, ≥50% was high expression), 21 cases were divided into Ki-67 high expression group(11 cases) and Ki-67 low expression group(10 cases). The DKI parameters of two groups were measured by two observers, included mean kurtosis(MK), axial kurtosis(Ka), radial kurtosis(Kr), fractional anisotropy of kurtosis(FAk), mean diffusivity(MD), axial diffusivity(Da), radial diffusivity(Dr) and fractional anisotropy(FA). The intra-class correlation coefficients(ICC) was used to test the consistency of the parameters measured results with the two observers. The two independent samples t test was used to compare the parameters of two groups. For the parameters that had the differential value, the ROC curve was used to evaluate their efficacy in the differential diagnosis of Ki-67 high and low expression groups. The Pearson correlation analysis was used to assess the correlation between the values of each parameter and Ki-67 expression index. Results: The data consistency of two observers was good(ICC>0.75). The MK, Ka, Kr, FAk, MD, Da, Dr and FA values of Ki-67 high expression group were 1.05±0.13, 1.17±0.21, 0.95±0.14, 0.41±0.14, (0.93±0.18) μm2/ms, (1.19±0.17) μm2/ms, (0.80±0.21) μm2/ms, 0.27±0.11, respectively. The parameters of Ki-67 low expression group were 0.79±0.10, 0.86±0.12, 0.72±0.14, 0.35±0.11, (1.33±0.28) μm2/ms, (1.64±0.37) μm2/ms, (1.17±0.25) μm2/ms, 0.23±0.08, respectively. The difference of MK, Ka, Kr, MD, Da and Dr values was statistically significant(P<0.05). The FAk, FA values of two groups were not statistically significant(P>0.05). The area under curve(AUC) of MK, Ka, Kr, MD, Da, Dr values to diagnose Ki-67 high expression were 0.982, 0.900, 0.900, 0.900, 0.973, 0.882, respectively. The boundary values were 0.92, 1.09, 0.85, 1.08 μm2/ms, 1.41 μm2/ms, 0.96 μm2/ms, respectively. The sensitivity was 90.9%, 72.7%, 81.8%, 81.8%, 100%, 81.8%, the specificity was 100%, 100%, 90%, 90%, 90%, 90%, respectively. The MK, Ka, Kr values were positively correlated with the Ki-67 expression index, the MD, Da, Dr values were negatively correlated with the Ki-67 expression index(P<0.05), and there were no correlation between the FAk and FA valueswith the Ki-67 expression index(P>0.05). Conclusion: The MK, Ka, Kr, MD, Da, Dr values of DKI sequence are related to the expression of Ki-67, and have the potential to reflect the proliferation of EC cells. MK value is the best parameter.

Key words： Endometrial neoplasms Ki-67 antigen Magnetic resonance imaging

Received: 10 August 2018

PACS:	Ｒ737.33
	Ｒ445.2

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	Articles by authors
	TIAN Shi-feng
	LIU Ai-lian
	ZHU Wen
	WANG Xue-dong
	SONG Qing-wei
	GUAN Hong-wei
	LI Ye
	LIU Jing-hong

Cite this article:

TIAN Shi-feng,LIU Ai-lian,ZHU Wen, et al. The value of multiple quantitative parameters of diffusion kurtosis imaging sequence to evaluate the expression of Ki-67 in endometrial carcinoma: a preliminary study[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(11): 808-813.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.11.010 OR http://www.jccmi.com.cn/EN/Y2018/V29/I11/808

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