磁共振动态增强定量灌注成像方法对子宫良恶性病变的鉴别作用  

Quantitative dynamic contrast-enhanced magnetic resonance imaging measurements in differential diagnosis of benign and malignant lesions of uterus

作　　者：郭永梅[1] 黄云海[1] 魏新华[1] 刘国顺[1] 杨蕊梦[1] 徐向东[1] 李雪丽[1] 

机构地区：[1]广州市第一人民医院放射科,广东广州510180

出　　处：《实用放射学杂志》2016年第11期1729-1732,1777,共5页Journal of Practical Radiology

摘　　要：目的探讨磁共振动态增强定量灌注成像方法在子宫良恶性病变鉴别诊断中的价值。方法回顾性分析首诊经病理证实为子宫恶性肿瘤18例（恶性病变组），良性肿瘤或肿瘤样病变22例（良性病变组），及正常子宫肌层25例（正常对照组）。均行3．0T磁共振动态增强扫描，并使用SIEMENS TISSUE 4D软件进行图像后处理，采用Tofts药代模型，分别测得感兴趣区的容积定量灌注参数值：容量转移常数（Ktrans）、速率常数（Kep）、血管外细胞外间隙容积比（Ve）值。对3组的定量灌注参数值进行单因素方差分析，多个样本均数的两两比较。结果3组的灌注参数平均值：Ktrans值分别是恶性病变组（0．178±0．068）min^-1、良性病变组（0．182±0．096）min^-1、正常对照组（O．263±0．111）min^-1；Ktrans值分别是（o．4土0．101）min^-1、（0．378±0．185）min^-1、（0．451士0．166）min^-1；Ve值分别是0．477±0．143、0．589±0．176、0．613±0．146。恶性病变组平均Ve值比良性病变组低（P=0．037）；恶性病变组平均Ktrans及V。值均较正常对照组低，且两两比较差异有统计学意义（P=0．003、P=0．004）。良性病变组平均Ktrans值较正常对照组低，且差别有统计学意义（P=0．011）。结论磁共振定量动态增强参数Ktrans及Ve值对子宫良恶性病变鉴别诊断具有一定的意义。Objective To evaluate quantitative dynamic contrast-enhanced magnetic resonance imaging {DCE-MRI） measure- ments in differential diagnosis of benign and malignant lesions of uterus. Methods 40 lesions were divided into two groups consisting of malignant group （18 cases） and benign group （22 cases）, 25 cases of normal myometrium were considered to be control group. Pharmacokinetic modeling of Torts with a modeled vascular input function was used for the quantitative measurements volume： transfer constant （K ）, reverse volume transfer constant （Kep ） , the extravascular extracellular space volume per unit volume of tissue { Ve ）. The correlation of these measurements in each of the three groups was investigated. Results Ktrans was （0. 178±0.068） min^-1 in malignant, （0. 182±0. 096） rain-1 in benign group and （0. 263±0. 111） min^-1 in control group. Kep was （0.4±0. 101 ） min^-1 in malignant, （0.378±0. 185） min^-1 in benign group and {0. 451±0. 166） min^-1 in control group. Ve was 0. 477±0. 143 in malignant, 0. 589±0. 176 in benign group and 0. 6134-0. 146 in control group. There was significant difference between the malignant group and benign group in V, （P= O. 037 ）, between the malignant group and control group in K and V. （P= O. 003, P= 0. 004} and between the benign group and control group （P= O. 011} in Ktrans, but no statistical differences was found between each two groups in Kep. Conclusion K and V. may be useful in differential diagnosis of benign and malignant lesions of uterus.

关 键 词：子宫 病变 动态增强磁共振成像 

分 类 号：R711.32[医药卫生—妇产科学] R445.2[医药卫生—临床医学]