正常子宫肌层ADC值在增殖期和分泌期的可重复性研究  

Reproducibility of apparent diffusion coefficient in the normal myometrium in proliferating phases and secretory phases

作　　者：陈波[1] 吕富荣[2] 肖智博[2] 盛波[2] CHEN Bo;LU Furong;XIAO Zhibo;SHENG Bo(Department of Ultrasound,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院超声科,重庆400016 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《磁共振成像》2020年第8期647-650,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：卫生部科学研究基金(编号:W2014RQ01)。

摘　　要：目的探讨正常子宫肌层ADC值测量的观察者内、观察者间的一致性以及可重复性。材料与方法采用3.0 T磁共振仪对34名健康女性(增殖期18名,分泌期16名)进行2次盆腔MR扫描,前后两次扫描间隔一个月经周期(28~32 d)。由两名放射科医师对子宫肌层ADC值行双盲法测量,每一次扫描同一名医师间隔一周进行两次测量,分析正常子宫肌层ADC值测量的观察者内的一致性、观察者间的一致性以及两次扫描在增殖期和分泌期的可重复性。结果两次MRI扫描两名医师测得到的子宫肌层ADC值的观察者内及观察者间一致性均较好,其组内相关系数(intraclass correlation coefficient,ICC)均>0.75。两名医师测量的子宫肌层ADC值在分泌期均大于增殖期,且差异具有统计学意义(P均<0.05)。增殖期和分泌期的子宫肌层ADC值在前后两次检查差异均无统计学意义(P均>0.05),在进一步进行Bland-Altman分析发现两名医师测量得到的子宫肌层ADC值在增殖期95%的置信区间分别为:-14.3%~13.6%和-11.5%~12.8%,在分泌期95%的置信区间分别为:-7.6%~7.0%和-7.7%~7.8%,因此分泌期的可重复性相对于增殖期较好。结论正常子宫肌层ADC值测量的观察者内及观察者间一致性较好,为正常子宫肌层ADC值的临床应用提供了证据,但正常子宫肌层ADC值可重复性在分泌期较增殖期好。Objective:To evaluate the intra-and inter-observer consistency,reproducibility of the measurement of apparent diffusion coefficient(ADC)values of normal myometrium.Materials and Methods:34 healthy females(18 in the proliferating phases;16 in the secretory phases)underwent two MR scanning sessions with an interval of one menstrual cycle(28-32 days).The ADC values of normal myometrium were double-blind measured twice with an interval of one week in each session by two radiologists.Then tested intraand inter-observer consistency,and analyzed reproducibility of myometrial ADC values in two sessions.Results:Intra-and inter-observer consistency of myometrial ADC values in two missions were both very good,their intraclass correlation coefficients(ICCs)were both greater than 0.75.The myometrial ADC values in the secretory phase were larger than these in the proliferating phase in each session(P<0.05).The ADC values of myometrium in proliferative phase and secretory phase showed no significant difference between the two missions(P>0.05),and further analysis of Bland-Altman found that the 95% confidence intervals in the proliferating phase were -14.3%-13.6% and -11.5%-12.8%,but in the secretory phase were -7.6%-7.0% and -7.7%-7.8%.The reproducibility of ADC value in the secretory phase of myometrium was better than that in the proliferative phase.Conclusions:The intra-and inter-observer consistency of myometrial ADC values measurement are satisfied,these provided more evidence for widely applying in clinic.But reproducibility of normal myometrial ADC values measurement in the secretory phase was better than that in the proliferative phase.

关 键 词：磁共振成像 表观扩散系数 子宫肌层 可重复性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R711.7[医药卫生—诊断学]