| 赵娓娓,宦 怡,郑敏文,张劲松,田 健,全志永.DCE-MRI药代动力学参数评估患癌胰腺不同区域功能状态的价值研究[J].,2020,(16):3011-3016 |
| DCE-MRI药代动力学参数评估患癌胰腺不同区域功能状态的价值研究 |
| The Value of DCE-MRI Pharmacokinetic Parameters in Evaluating the Functional Status of Different Regions of Pancreatic Cancer |
| 投稿时间：2020-02-10 修订日期：2020-02-28 |
| DOI：10.13241/j.cnki.pmb.2020.16.003 |
| 中文关键词: 胰腺癌 动态对比增强磁共振成像 药代动力学参数 功能状态 |
| 英文关键词: Pancreatic cancer Dynamic contrast-enhanced MRI Pharmacokinetic parameters Functional status |
| 基金项目:国家自然科学基金项目（81220108011）；西京医学学科助推计划（XJZT19ML03） |
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| 中文摘要: |
| 摘要 目的：比较胰腺癌（pancreatic cancer, pCa）患者癌灶区、近端胰腺区、远端炎性区及正常胰腺的动态对比增强磁共振成像（dynamic contrast-enhanced MRI, DCE-MRI）药代动力学参数Ktrans和k ep ，无创量化患癌胰腺不同区域微血管功能状态，评估pCa近端胰腺组织是否为相对正常的胰腺组织。方法：收集病理及临床证实的pCa患者29例，随机选取正常志愿者30例。所有受试者行胰腺DCE-MRI扫描并计算每个观测区的Ktrans和kep。根据患癌胰腺不同区域状态的差异，将其分为pCa组、癌灶近端胰腺组、癌灶远端炎症组，30例正常志愿者胰腺为正常对照组。采用One-way ANOVA分别比较不同组别间Ktrans、k ep 的差异。结果：胰腺癌、近端胰腺区、远端炎症区及正常胰腺的Ktrans和k ep 分别是0.114±0.023、0.066±0.009、0.323±0.026、0.061±0.005和0.341±0.077、0.105±0.017、0.772±0.068、0.107±0.005。pCa的Ktrans和k ep 高于近端胰腺区和正常胰腺，而低于远端炎症区，远端炎症区的Ktrans和k ep 高于pCa、近端胰腺区和正常胰腺，以上P均<0.001；而近端胰腺和正常胰腺的Ktrans和k ep 均无统计学差异（P=0.298、0.893）。结论：患癌胰腺不同区域微血管功能状态有明显差异，同时提示pCa近端≥1 cm的区域为相对正常的胰腺区，以上可为pCa精准治疗、手术切缘选择提供参考。 |
| 英文摘要: |
| ABSTRACT Objective: To compare dynamic contrast-enhanced MRI(DCE-MRI) pharmacokinetic parameters K trans , k ep of normal pancreas and the tumor region, proximal pancreatic region, distal inflammatory region in patients with pancreatic cancer, and to non-invasively quantify the functional status of different regions of the pancreas with cancer. To evaluate whether the proximal pancreatic tissue adjacent to pCa is normal. Methods: 29 histologically and clinically proven patients with pancreatic cancer and 30 normal volunteers underwent DCE-MRI. DCE-MRI pharmacokinetic parameters (K trans and k ep ) for each observation region were calculated. Pancreases with cancer were divided into pancreatic cancer, proximal pancreas and distal inflammation groups. Pancreases of 30 normal volunteers were as normal control group. One-way ANOVA test were used to evaluate the differences of K trans and k ep among different groups. Results: K trans and k ep in pancreatic cancer, proximal pancreatic region, distal inflammatory region and normal pancreas were 0.114±0.023, 0.066±0.009, 0.323±0.026, 0.061±0.005 and 0.341±0.077, 0.105±0.017, 0.772±0.068 and 0.107±0.005, respectively. The K trans and k ep of pCa were higher than that of proximal pancreas region and normal pancreas, and lower than that of distal inflammatory region (P all <0.001). However there were no significant differences of K trans and k ep between proximal pancreas region and normal pancreas (P=0.298, 0.893). Conclusion: There are differences of microcirculation function for different regions of pancreases with cancer. Proximal pancreas region away from tumor ≥1 cm is relatively normal pancreas. These provide references for precise treatment and surgical margin selection of pancreatic cancer. |
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