MRI测量子宫结合带厚度对预测子宫内膜异位症的价值  

Value of uterine junctional zone thickness in diagnosing of endometriosis：an MRI study

作　　者：刘玉洁[1] 王庭伟[2] 冯倩[3] 宗利丽[1,2] 邱士军[2] 

机构地区：[1]南方医科大学,广东广州510515 [2]广州中医药大学第一附属医院影像科,广东广州510405 [3]广州中医药大学,广东广州510405

出　　处：《实用放射学杂志》2017年第1期72-75,共4页Journal of Practical Radiology

摘　　要：目的 探讨动态增强磁共振成像（DCE-MRI）定量参数容积转运常数（Ktrans）在评估肠道克罗恩病（CD）病变活动性中的应用价值。方法 分析50例回盲部单发病灶的CD患者，对病变部位行DCE-MRI扫描，测量Ktrans。同时收集临床数据，包括Harvey-Bradshow指数（HBI）和C反应蛋白（CRP）。（1）评价Ktrans的可信度、可重复性；（2）将50例CD患者病变肠壁的Ktrans值与各自相应的血清CRP，HBI作相关分析；（3）根据HBI指数将50例CD患者病变肠管分为重度活动组，轻中度活动组和静止组，比较3组间Ktrans值差异性。结果 （1）病变肠壁的Ktrans值可信度高（Cronbach’s Alpha信度系数=0.993）；（2）Ktrans值与HBI呈正相关（r=0.635，P〈0.001）；Ktrans值与血清CRP呈正相关（r=0.764，P＜0.001）；（3）静止组和轻中度活动组之间Ktrans有统计学差异（P〈0.001），静止组和重度活动组之间Ktrans有统计学差异（P〈0.001），轻中度活动组和重度活动组之间Ktrans有统计学差异（P〈0.001）。结论 MRI定量参数Ktrans具有较高的可信度，能够反映CD活动状态，具有临床应用价值。Objective To investigate the value of uterine junctional zone （JZ） thickness in diagnosing endometriosis （EMS} by MRI.Methods A total of 42 female patients with benign ovarian tumors were analyzed retrospectively. Based on the laparoscopic and/or pathological examination results, the patients were divided into the EMS group （21 cases） and non-EMS group （21 cases）, then the EMS group was further divided into the mild to moderate （stage Ⅰ-Ⅲ） EMS group （10 cases） and the severe （stage Ⅳ） EMS group （11 cases） based on the revised American Fertility Society （r-AFS） classification. Using MRI, all of the JZ values, in- cluding the maximum and minimum JZ thickness （JZmax, JZmin）, total myometrial thickness of JZmax （JZmaxM）, difference between JZmax and JZmin （JZdif）, JZmax/JZmin, JZmax/JZmaxM and jZmin/JZmaxM were measured. T-test was used to analyze all the JZ values between the EMS group and non-EMS group, as well as the mild to moderate EMS group and the severe EMS group. The receiver operating characteristic （ROC） curve was used to assess the preoperative MRI results and the JZ values diagnosing EMS. Results The values of JZmax （ P 〈 0.05 ）, JZdif and JZmax/JZmin （ P 〈0. 01, respectively） were significantly higher in the EMS group than those in the non-EMS group. No JZ values showed any difference between the mild to moderate EMS group and the severe EMS group. The sensitivity and specificity of preoperative MRI results were 61.9 % and 90.5 %, respectively. Using JZdif and JZmax/J Zmin of 4.50 and 2.42 respectively as the ROC cut-off points, the diagnostic sensitivities were 89.5% and 90.5 %, respectively, and the specificities were both 71.4 % 0.Conclusion The thickened JZ on MRI image is associated with EMS,irrelevant to the severity of EMS. If JZdif≥4.5 mm or JZmax/JZmin≥2.42, the surgeons should be aware of EMS in laparoscopy.

关 键 词：子宫内膜异位症 磁共振成像 子宫结合带 

分 类 号：R711.71[医药卫生—妇产科学] R445.2[医药卫生—临床医学]