非增强MRI多参数鉴别富细胞型与退变型子宫平滑肌瘤  

Non-enhancement MRI multiparameters for differential diagnosis of cellular and degeneration uterine leiomyomas

作　　者：田士峰[1] 刘爱连[1] 魏强[1] 陈丽华[1] TIAN Shifeng;LIU Ailian;WEI Qiang;CHEN Lihua(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 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

出　　处：《中国医学影像技术》2022年第4期555-560,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价非增强MRI多参数鉴别诊断富细胞型(CUL)与退变型子宫平滑肌瘤(DUL)的价值。方法纳入17例CUL及51例DUL患者,于术前盆腔MR T1WI及脂肪抑制T2WI中勾画病灶及髂腰肌ROI,计算其信号比值(T1_(R)、T_(2)R);测量弥散峰度成像(DKI)中相同位置病灶ROI的平均弥散峰度(MK)、平均弥散系数(MD)和各向异性分数(FA),以及增强T2^(*)加权血管成像(ESWAN)幅度、相位、R2^(*)和T2^(*),比较组间各参数差异。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各参数单独及联合鉴别CUL与DUL的效能,并比较其效能差异。结果CUL组T_(2)R、T2^(*)均高于DUL组(P均<0.05),MD、R2^(*)均低于DUL组(P均<0.05);组间T1_(R)、MK、FA、幅度及相位差异均无统计学意义(P均>0.05)。T_(2)R、MD、R2^(*)及T2^(*)鉴别CUL与DUL的AUC分别为0.566、0.703、0.707及0.705;MD+R2^(*)、MD+T2^(*)及MD+R2^(*)+T2^(*)联合鉴别诊断的AUC分别为0.813、0.799及0.802,各参数效能差异均无统计学意义(P均>0.05)。结论DKI、ESWAN序列参数鉴别CUL和DUL的效能均较高。Objective To observe the value of non-enhancement MRI multiparameters for differential diagnosis of cellular(CUL)and degeneration uterine leiomyomas(DUL).Methods Totally 17 patients with CUL and 51 patients with DUL were enrolled.ROI of the lesions and iliopsoas muscle were delineated on preoperative pelvic MR T1 WI and fat suppression T2 WI,and the signal ratios(T1_(R),T_(2)R)were calculated.The mean kurtosis(MK),mean diffusivity(MD)and fractional anisotropy(FA)in diffusion kurtosis imaging(DKI),as well as the amplitude,phase,R2^(*)and T2^(*)on enhanced T2 star weighted angiography(ESWAN)of ROI of lesions at the same location were measured,and the above parameters were compared between groups.The receiver operating characteristic(ROC)curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of every parameter alone and the combination of them for distinguishing CUL and DUL,respectively,and the efficacies were compared.Results T_(2)R and T2^(*)in CUL group were higher than those in DUL group(both P<0.05),and MD and R2^(*)were lower than those in DUL group(both P<0.05).There was no significant difference of T1_(R),MK,FA,amplitude nor phase between groups(all P>0.05).The AUC of T_(2)R,MD,R2^(*)and T2^(*)for distinguishing CUL and DUL was 0.566,0.703,0.707 and 0.705,respectively,of MD+R2^(*),MD+T2^(*)and MD+R2^(*)+T2^(*)was 0.813,0.799 and 0.802,respectively.No significant difference was found among the efficacies of the above parameters(all P>0.05).Conclusion Both DKI and ESWAN sequence parameters had high efficiency for identifying CUL and DUL.

关 键 词：子宫肿瘤 磁共振成像 

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