本研究的目的是前瞻性地研究使用集成切片特异性动态匀场 (iShim) 技术的体素内不相干运动 (IVIM) 在原发性食管鳞状细胞癌 (ESCC) 分期和预测 ESCC 淋巴结转移的存在中的诊断性能.2016 年 4 月至 2019 年 4 月前瞻性入组 63 名 ESCC 患者。使用 iShim 技术 (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm2) 进行 MR 和 IVIM术前3.0T MRI系统。原发肿瘤表观扩散系数（ADC）和IVIM参数，包括真扩散系数（D）、伪扩散系数（D*）、伪扩散分数（f）由两名独立放射科医生测量。评估不同T和N阶段的D、D*、f和ADC值的差异。计算组内相关系数（ICC）来评估两个读者之间观察者间的一致性。使用受试者工作特征（ROC）曲线分析确定 D、D*、f 和 A​​DC 值在 ESCC 原发肿瘤分期和预测淋巴结转移中的诊断性能。观察者间对于 IVIM 参数和 ADC 达成了良好的共识（ D：ICC = 0.922；D*：ICC = 0.892；f：ICC = 0.948；ADC：ICC = 0.958）。 T1  T2组的ADC、D、D*和f值显着高于T3  T4a组[ADC：（2.55 ± 0.43）×10- 3 mm2/s vs.（2.27 ± 0.40）×10- 3 mm2 /s，t = 2.670，P = 0.010； D: (1.82 ± 0.39) ×10- 3 mm2/s vs (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*: 46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f：0.45 ± 0.12 vs. 0.37 ± 0.12，t = 2.538，P = 0.014]。淋巴结阳性（N）组ADC、D、f值均显着低于淋巴结阴性（N0）组[ADC：（2.10±0.33）×10- 3 mm2/s vs.（2.55） ± 0.40)×10- 3 mm2/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10- 3 mm2/s vs (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P < 0.001; f：0.32 ± 0.10 vs. 0.45 ± 0.11，t=-4.524，P < 0.001]。 D、D* 和 f 的组合在区分 T1  T2 组和 T3  T4a 组时产生最高的曲线下面积 (AUC) (0.814)。 D 与 f 结合在识别 ESCC N   组和 N0 组时提供了最高的诊断性能（AUC = 0.849）。 IVIM 可作为有效的功能成像技术来评估原发肿瘤的术前分期并预测 ESCC 是否存在淋巴结转移.© 2024。作者。

The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm2) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D*, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D*, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D*: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D* and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*: 46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10- 3 mm2/s vs. (2.55 ± 0.40) ×10- 3 mm2/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10- 3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D* and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.© 2024. The Author(s).