磁共振扩散张量成像定量参数鉴别Ⅰ期子宫内膜癌与子宫内膜息肉的价值  

The value of the quantitative parameter of MR DTI in differential diagnosis of stageⅠendometrial carcinoma and endometrial polyps

作　　者：王学东 刘爱连[1] 田士峰[1] 孙旭[2] 宋清伟[1] WANG Xuedong;LIU Ailian;TIAN Shifeng;SUN Xu;SONG Qingwei(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China;Department of Pathology,the First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning Province 116011,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011 [2]大连医科大学附属第一医院病理科,辽宁大连116011

出　　处：《实用放射学杂志》2020年第8期1261-1265,共5页Journal of Practical Radiology

基　　金：首都科技领军人才培养工程项目(Z181100006318003).

摘　　要：目的探讨MR DTI定量参数对Ⅰ期子宫内膜癌(EC)与子宫内膜息肉(EP)的鉴别价值.方法回顾性分析经手术病理证实的Ⅰ期30例EC患者和27例EP患者,术前均行1.5T MRI检查(含DWI和DTI序列).由2位观察者分别测量2组病灶实质区DWI的ADC值、DTI的ADC(ADCT)值和FA值,比较2位观察者测量结果的一致性和2组病灶间各参数值的差异,评估有统计学差异参数的鉴别效能,比较ADCT、FA和ADC值之间AUC的差异.结果2位观察者测量各组数据的一致性良好(ICC>0.75);EC组的ADCT、ADC值均小于EP组,EC组的FA值大于EP组,分别为(1.062±0.232)×10^-9 vs(1.656±0.305)×10^-9 mm2/s、(0.987±0.199)×10^-3 vs(1.285±0.355)×10^-3 mm2/s、0.153±0.054 vs 0.118±0.050,差异有统计学意义(P<0.05).以ADCT、ADC、FA值分别为1.368×10^-9 mm2/s、1.03×10^-3 mm2/s、0.135作为鉴别诊断阈值,敏感度和特异度分别为88.9%和100%、100%和66.7%、63.3%和80.5%,AUC值分别为0.985、0.896和0.746.ADCT和ADC值的AUC有统计学意义,FA和ADC值的AUC无统计学意义.结论DTI定量参数可有效鉴别Ⅰ期EC和EP,DTI的ADCT值较DWI的ADC值具有更好的诊断效能.Objective To investigate the dfferential value of MR DTI for stage I endometrial carcinoma(EC)and endometrial polyp(EP).Methods The data of 30 patients with stage I EC and 27 patients with EP onfirmed by postoperative pathological examnination were analyzed retrospectively.all patients underwent 1.5T MRI(including DWI and DTI sequence)examination before operation.The ADC value of DWI and the ADCT and FA values of DT1 in focal parenchymal areas were measured by two observers.The consistency of measurement results between the two observers and the difference of each parameter between the two groups were compared,the differential eficacy of the parameters with statistical difference was evaluated,and the differences in AUC among ADCT,FA and ADC values were compared.Results The consistency of the data obtained by two observers was good(ICC>0.75).ADCT,ADC values of EC group were less than that of EP group,and FA value of EC group were greater than that of the EP group,their values were(1.062±0.232)×10^-vs(1.656±0.305)×10^^-9 mm^2/s,(0.987±0.199)×10^^-3vs(1.285±0.355)×10^^-3 mm^2/s,0.153+0.054 vs 0.18±0.050 repctively(all P<0.05).ADCT,ADC and FA values were 1.368×10^^-9 mm^2/s,1.03×10^^-3 mm^2/s and 0.135 respectively as the dfferential diagnosis thresholds,the corresponding diagnostic sensitivity and specificity were 88.9%and 100%,100%and 66.7%,63.3%and 80.5%,respectively,AUC were 0.985,0.896 and 0.746,respectively.There were statistical differences of the AUC value between ADCT and ADC values,and there was no statistical difference of the AUC value between FA and ADC values.Conclusion The quantitative parameters of DTI can ffectively differentiate stage I EC from EP,ADCT value of DTI has more diagnostic value than ADC value of DWI.

关 键 词：子宫内膜肿瘤 磁共振成像 扩散张量成像 

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