磁共振波谱及扩散加权成像对子宫良恶性肿瘤的鉴别诊断价值  

Study of MR Spectroscopy and Diffusion Weighted Imaging in Differentiating Benign from Malignant Uterine Tumors

作　　者：马凤华[1] 张国福[1] 强金伟 田晓梅[1] 李海明 MA Feng-hua;ZHANG Guo-fu;QIANG Jin-wei;TIAN Xiao-mei;LI Hai-ming

机构地区：[1]复旦大学附属妇产科医院影像科 [2]复旦大学附属金山医院影像科

出　　处：《中国医学计算机成像杂志》2018年第4期316-320,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析子宫肿瘤的氢质子磁共振波谱(1H-MRS)及扩散加权成像(DWI)表现,探讨1H-MRS及DWI鉴别子宫良恶性肿瘤的价值。方法:回顾性分析经手术和病理证实的44例子宫肿瘤(良性31例,恶性13例)的DWI和1H-MRS资料,以Cr为内参照,波谱后处理软件自动计算各代谢物与其比值;并记录肿瘤的ADC值。统计学比较良恶性肿瘤之间的代谢物比值及ADC值差异,进行ROC曲线分析确定鉴别良恶性肿瘤的诊断阈值。结果:良、恶性子宫肿瘤的ADC值、Cho/Cr比值、Lip/Cr分别为(1.15±0.2)×10^(-3)mm^2/s和(0.75±0.1)×10^(-3)mm^2/s,3.74±1.4和7.01±2.9,5.28±2.7和11.69±4.2,差异均有显著统计学意义(P<0.05)。ADC值及Cho/Cr比值的ROC曲线面积分别为0.981和0.854,以ADC值=0.885×10^(-3)mm^2/s、Cho/Cr=6.01为阈值,鉴别良恶性肿瘤的敏感性、特异性分别为90%和85%、69%和97%。结论:子宫良、恶性肿瘤的1H-MRS模式及ADC值不同,Cho/Cr、Lip/Cr比值及ADC值有助于两者的鉴别。Purpose： To investigate the proton magnetic resonance spectroscopy （~H-MRS） and diffusion weighted imaging （DWI） features of uterine tumors, and to evaluate the value of 1H-MRS and DWI in differentiating benign from malignant uterine tumors. Methods： Forty-four patients with surgically and histologically proven uterine tumors underwent DWI and ~H-MRS. Single-voxel or multi-voxel spectroscopy was performed using the point resolved spectroscopy localization technique. The Cho/Cr, NAA/Cr, Lac/Cr, Lip/Cr ratios and ADC values were recorded and compared between benign and malignant tumors. Results： The ADC values, Cho/Cr ratio and Lip/Cr ratio of benign and malignant uterine tumors were （1.15±0.2）×10^-3mm^2/s vs （0.75±0.1）×10^-3mmE/s, 3.74±1.4 vs 7.01±2.9, 5.28±2.7 vs 11.69±4.2, respectively, （all P〈0.05）. Areas under the curves （AUC） of the ADC values and Cho/Cr ratios were 0.981 and 0.854 for differentiating benign from malignant uterine tumors. The threshold of ADC values, Cho/Cr ratios were 0.885×10^-3mm^2/s and 6.01, with a sensitivity and specificity of 90% and 85%, 69% and 97%, respectively. Conclusions： The 1H-MRS patterns and ADC values of benign and malignant uterine tumors are different. The Cho/Cr, Lip/Cr ratios and ADC values can be used to differentiate benign from malignant uterine tumors.

关 键 词：子宫肿瘤 磁共振成像 波谱 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]