扩散峰度成像多定量参数鉴别子宫肉瘤与变性肌瘤的价值  

The value of diffusional kurtosis imaging in differentiating uterine sarcoma from degenerative hysteromyoma

作　　者：鞠烨[1,2] 聂健 田士峰 刘爱连[1,2] 陈丽华 魏强[1,2] JU Ye;NIE Jian;TIAN Shifeng;LIU Ailian;CHEN Lihua;WEI Qiang(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging,Dalian 116011,China;Dalian Medical University,Dalian 116044,China)

机构地区：[1]大连医科大学附属第一医院放射科,大连116011 [2]大连市医学影像人工智能工程技术研究中心,大连116011 [3]大连医科大学,大连116044

出　　处：《磁共振成像》2021年第10期61-65,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的研究MR扩散峰度成像(diffusion kurtosis imaging,DKI)多定量参数对子宫肉瘤(uterine sarcoma,US)与变性子宫肌瘤(degenerative hysteromyoma,DH)的鉴别价值。材料与方法本文为回顾性研究,分析13例确诊US与26例DH患者临床资料与MRI、DKI图像,记录两组病灶实质区内DKI参数值:平均扩散峰度值(mean kurtosis,MK)、平行扩散峰度值(axial kurtosis,Ka)、垂直扩散峰度值(radial kurtosis,Kr)、峰度各向异性分数(fractional anisotropy of kurtosis,FAK)、平均扩散系数值(mean diffusivity,MD)、平行扩散系数值(axial diffusivity,Da)、垂直扩散系数值(radial diffusivity,Dr)以及各向异性分数(fractional anisotropy,FA)。评估两名观察者对两组病灶的DKI结果观测的一致性,分析这些参数在两组间的差异,并用受试者工作特征(receiver operating characteristic,ROC)曲线评估DKI多定量参数判断US的效能。结果除US组Kr、FAK参数值一致性中等外(0.40≤ICC≤0.75),2名观察者测量所得的这些参数一致性高(ICC>0.75)。US组的MK、Ka、Kr、FA、FAK、MD、Da、Dr值分别为0.86±0.13、0.92±0.17、0.78±0.13、0.20±0.08、0.30±0.13、(1.18±0.26)μm^(2)/ms、(1.41±0.32)μm^(2)/ms、(1.06±0.25)μm^(2)/ms,DH组各参数值分别为0.66±0.09、0.61±0.08、0.65±0.09、0.26±0.08、0.29±0.09、1.71(1.54,1.89)μm^(2)/ms、2.17(2.04,2.38)μm^(2)/ms、(1.53±0.34)μm^(2)/ms。US组的MK、Ka、Kr值大于DH组,FA、MD、Da、Dr值小于DH组,差异有统计学意义(P<0.05);FAK值差异无统计学意义(P>0.05)。MK、Ka、Kr、FA、MD、Da、Dr值预估曲线下面积(area under curve,AUC)分别为0.93、0.99、0.80、0.73、0.94、0.97、0.90,预估的各参数界值为MK≥0.80、Ka≥0.73、Kr≥0.75、FA≥0.22、MD≤1.47、Da≤1.95、Dr≤1.23,其敏感度分别为:76.9%、100.0%、61.5%、76.9%、92.3%、100.0%、76.9%,其特异度分别为:100.0%、96.2%、88.5%、73.1%、92.3%、84.6%、88.5%。结论DKI参数对鉴别US和DH有较高的应用价值,值得进�Objective:To compare the value of MR diffusion-kurtosis imaging(DKI)with several parameters in differentiating uterine sarcoma(US)and degenerative hysteromyoma(DH)for providing a valuable method for the differential diagnosis of the two parenchyma tumors of uterus.Materials and Methods:The data of 39 patients with 13 cases of US and 26 cases of DH were enrolled in this study and inspected conventional MR(T1WI,T2WI)and DKI-MR examination with 1.5 T MR imager.DKI parameters(MK,Ka,Kr,FAK,MD,Da,Dr and FA)of USs and DHs were measured by using the FuncTool on GE AW4.6 workstation.The MR images were blindly reviewed and analyzed by two observers.The consistency of each parameter measured by the two observers was analyzed,and compared value of parameters.The effectiveness of each parameter value in identifying the two groups were assessed using the receiver operating characteristic(ROC)curve.Results:Except for the parameters of Kr and FAK of the US group were in moderate consistency(0.40≤ICC≤0.75),other parameters measured by the 2 observers were showed a good consistency(ICC>0.75).MK,Ka,Kr,FA,FAK,MD,Da and Dr of US group were 0.86±0.13,0.92±0.17,0.78±0.13,0.20±0.08,0.30±0.13,(1.18±0.26)μm^(2)/ms,(1.41±0.32)μm^(2)/ms,(1.06±0.25)μm^(2)/ms,respectively.The parameters of the DH group were 0.66±0.09,0.61±0.08,0.65±0.09,0.26±0.08,0.29±0.09,1.71(1.54,1.89)μm^(2)/ms,2.17(2.04,2.38)μm^(2)/ms,(1.53±0.34)μm^(2)/ms.The MK,Ka and Kr values of US group were higher than those of the DH group,and the FA,MD,Da and Dr values were lower than those of the DH group,with statistically significant differences(P<0.05).There was no statistical difference in FAK value(P>0.05).The AUC values of MK,Ka,Kr,FA,MD,Da and Dr were 0.93,0.99,0.80,0.73,0.94,0.97 and 0.90.The diagnostic threshold of the parameters were as follows:MK≥0.80,Ka≥0.73,Kr≥0.75,FA≥0.22,MD≤1.47,Da≤1.95,Dr≤1.23.The sensitivity was 76.9%,100.0%,61.5%,76.9%,92.3%,100.0%,76.9%,and the specificity was 100.0%,96.2%,88.5%,73.1%,92.3%,84.6%,88.5%,respe

关 键 词：子宫肉瘤 变性子宫肌瘤 磁共振成像 扩散峰度成像 鉴别诊断 定量参数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]