2025 年第 9 期 第 20 卷

磁共振成像三维超短回波时间序列在非小细胞肺癌预后评估中的价值

The prognostic value of three dimensional ultra-short echo time sequence of magnetic resonance imaging in non-small cell lung cancer

作者：田中雨苏浩然宋璇梁志宏闫文磊

英文作者：Tian Zhongyu Su Haoran Song Xuan Liang Zhihong Yan Wenlei

单位：河北省衡水市第二人民医院影像科，衡水053000

英文单位：Department of Imaging Hengshui Second People′s Hospital Hebei Province Hengshui 053000 China

关键词：非小细胞肺癌；磁共振成像；三维超短回波时间序列；诊断效能

英文关键词：Non-smallcelllungcancer;Magneticresonanceimaging;Three-dimensionalultra-shortechotimesequence;Diagnosticefficiency

• 摘要：

• 目的 分析磁共振成像（MRI）三维超短回波时间（UTE）序列在非小细胞肺癌（NSCLC）预后评估中的价值。方法 选取河北省衡水市第二人民医院2020年1月至2024年2月收治的NSCLC患者220例，均行常规MRI、三维UTE序列MRI检查，以病理活体组织检查结果为标准，分析常规MRI与三维UTE序列MRI对NSCLC临床分期的诊断效能；随访1年分为良好预后组（141例）和不良预后组（79例），比较2组肺功能、完全呼气状态下UTE信号强度（SIN）、UTE-T*2等资料。分析临床指标与患者预后的关系以及UTE序列对NSCLC预后的诊断价值。结果 220例NSCLC患者经病理活体组织检查确诊处于TNM分期Ⅰ期34例、Ⅱ期70例、ⅢA期116例，常规MRI与病理活体组织检查一致性为0.824（P<0.05），三维UTE序列与病理活体组织检查的一致性为0.945（P<0.05）。SIN在TNM分期Ⅰ、Ⅱ、Ⅲ期患者中呈降低趋势，UTE-T*2呈上升趋势（均P<0.001）。不良预后组患者年龄、TNM分期为ⅢA比例、肿瘤直径、淋巴结转移比例、UTE-T*2均高于良好预后组（P<0.01），SIN低于良好预后组（P<0.05）。二元Logistic回归分析显示，年龄、TNM分期、肿瘤直径、淋巴结转移和UTE-T*2均是NSCLC患者预后不良的危险因素，SIN高是NSCLC患者预后不良的保护因素（均P<0.01）。受试者工作特征曲线分析结果显示，SIN和UTE-T*2联合诊断NSCLC预后的曲线下面积为0.828，敏感度和特异度分别为89.97%、80.14%。结论 MRI三维UTE序列可有效鉴别NSCLC临床分期，其量化参数与NSCLC患者预后有一定关联，可用于NSCLC临床诊断。

• Objective To analyze the value of magnetic resonance imaging (MRI) three-dimensional ultra-short echo time (UTE) sequence in the prognosis evaluation of non-small cell lung cancer (NSCLC). Methods A total of 220 patients with NSCLC admitted to Hengshui Second People′s Hospital, Hebei Province from January 2020 to February 2024 were selected. All patients underwent conventional MRI and three-dimensional UTE sequence MRI. The results  of pathological biopsy were used as the standard to analyze the diagnostic efficacy of conventional MRI and three-dimensional UTE sequence MRI in the clinical staging of NSCLC. After a 1-year follow-up, patients were divided into a good prognosis group (141 cases) and a poor prognosis group (79 cases). Data such as lung function, signal intensity (SIN) of UTE during full expiration, and UTE-T*2 were compared between the two groups. The relationship between clinical indicators and prognosis of patients and the diagnostic value of UTE sequence in the prognosis of NSCLC were analyzed. Results Among 220 NSCLC patients, 34 cases were diagnosed as TNM stage Ⅰ, 70 cases as TNM stage Ⅱ and 116 cases as TNM stage ⅢA by pathological biopsy. The consistency between conventional MRI and pathological biopsy was 0.824 (P<0.05), and the consistency between the three-dimensional UTE sequence and pathological biopsy was 0.945 (P<0.05). SIN showed a downward trend and UTE-T*2 showed an upward trend in TNM stage Ⅰ, Ⅱ and Ⅲ patients(all P<0.001). Age, proportion of TNM stage ⅢA, tumor diameter, proportion of lymph node metastasis and UTE-T*2 in the poor prognosis group were higher than those in the good prognosis group(all P<0.01), and SIN was lower than that in the good prognosis group(P<0.05). Binary Logistic regression analysis showed that age, TNM stage, tumor diameter, lymph node metastasis and UTE-T*2 were risk factors for poor prognosis of NSCLC patients, and high SIN was a protective factor for poor prognosis of NSCLC patients (all P<0.05). The receiver operating characteristic curve analysis showed that the area under the curve of the combination of SIN and UTE-T*2 was 0.828, and the sensitivity and specificity were 89.97% and 80.14%, respectively. Conclusion MRI three-dimensional UTE sequence can effectively identify the clinical stage of NSCLC, and its quantitative parameters are related to the prognosis of NSCLC patients, which can be used for clinical diagnosis of NSCLC.