Reference Region和Extended Tofts药代动力学模型在鉴别富细胞型子宫肌瘤中的价值  

The value of DCE-MRI parameters of Reference Region and Extended Tofts model in differentiate hyper-cellular uterine leiomyoma

作　　者：王苏波[1,2] 赵振华 杨建峰[2] 赵丽[2] 杨立铭[2] 王诚[2] WANG Subo;ZHAO Zhenhua;YANG Jianfeng;ZHAO Li;YANG Liming;WANG Cheng(Department of Radiology,Shaoring Traditional Chinese Medicine,Shaoxing,Zhejiang Province 312000,China;Department of Radiology,Shaoxing Hospital of Zhejiang University,Shaoxing,Zhejiang Province 312000,China)

机构地区：[1]绍兴市中医院放射科,浙江绍兴312000 [2]浙江大学绍兴医院放射科,浙江绍兴312000

出　　处：《实用放射学杂志》2019年第5期780-784,共5页Journal of Practical Radiology

摘　　要：目的探讨Reference Region模型(RR模型)和Extended Tofts(ET模型)模型DCE-MRI定量灌注参数鉴别富细胞型子宫肌瘤的价值。方法连续收集2015年9月至2016年9月经手术病理证实的子宫肌瘤59例(普通型28例,富细胞型12例,退变型19例)病例资料。所有患者术前均行盆腔DCE-MRI检查,应用RR模型和ET模型分别计算子宫肌瘤的定量灌注参数,用ROC曲线评价其诊断富细胞型子宫肌瘤的效能;使用Pearson相关性分析2个模型间参数有无相关性。结果在3组子宫肌瘤间,RR模型的血管间隙至血管外细胞外间隙转运系数(Ktrans)、血管外细胞外间隙返回至血管内间隙速率常数(Kep)、血管间隙容积积分(Vp)及ET模型Ktrans、Kep、血管外细胞外间隙容积积分(Ve)、Vp值有统计学意义((P<0.05),且这些参数在鉴别富细胞型子宫肌瘤的AUC分别为0.835、0.752、0.706、0.956、0.871、0.656、0.754;RR模型的Ktrans与ET模型Ktrans相关(r=0.600,P=0.000),ET模型中的Kep与RR模型中的Kep、Vp相关(r=0.275,P=0.035;r=0.376,P=0.003)。结论RR模型中的Ktrans、Kep、Vp及ET模型的Ktrans、Kep、Ve、Vp在鉴别细胞型子宫肌瘤均具有较高的应用价值,特别是ET模型Ktrans、Kep诊断效能优于RR模型。Objective To analyze the value of the DCE-MRI parameters of Reference Region and Extended Tofts modle in the differential diagnosis of hyper-cellular uterine leiomyoma.Methods 59 patients with uterine leiomyoma confirmed by surgery and pathology were enrolled in the study from September 2015 to September 2016,including 28 cases of classical leiomyoma,12 cases of cellular leiomyoma and 19 cases of degenerative leiomyoma.All patients underwent DCE MRI before surgery.The quantitative perfusion parameters(transfer constant(K^trans),extravascular extracellular space volume ratio(Ve),efflux rate constant(Kp),and blood plasma volume ratio(Vp)were measured via Reference Region model(RR model)and Extended Tofts model(ET model)respectively.ROC curve was used to evaluate the efficiency of the quantitative perfusion parameters in differential diagnosis of hyper-cellular uterine leiomyoma.Pearson correlation analysis was also applied to observe the correlations among all equivalent parameters.Results Kmms and Kep in RR model and K^trans,Kep,Ve and Vp,in ET model showed statistical significances among three types of uterine leiomyoma(P<0.05),meanwhile,the AUCs of Krs,Kn and V,derived from RR model and K^trans,Kep,Ve and Vp calculated by ET model in diagnosis of cellular uterine leiomyoma were 0.835,0.752,0.706,0.956,0.871,0.656 and 0.754.The K^trans in the RR model was correlated with Kmms in the ET model(r=0.600,P<0.001),Kan in the ET model was positive correlated with Kep and Vp in RR model(r=0.275,P=0.035;r=0.376,P=0.003).Conclusion The value of K^trans,Kep and Vp in RR and K^trans,Kep,Ve and Vp in ET model can be useful in the differentiation of hyper-cellular leiomyoma,especially the values of Kms and Ken in ET model have higher diagnostic efficacy than those in RR model.

关 键 词：子宫肌瘤 富细胞型 磁共振成像 动态对比增强 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]