MRI ADC直方图在子宫内膜癌诊断及肿瘤浸润评估中的应用  

Application of MRI ADC Histogram in Diagnosis of Endometrial Cancer and Assessment of Tumor Infiltrating

作　　者：贺英[1] 刘晓娟[1] 王静[1] 常建苗 HE Ying;LIU Xiaojuan;WANG Jing;CHANG Jianmiao(Department of Gynaecology,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,P.R.China)

机构地区：[1]河北北方学院附属第一医院妇科,河北张家口075000

出　　处：《影像科学与光化学》2022年第5期1093-1097,共5页Imaging Science and Photochemistry

基　　金：2021年度河北省医学科学研究课题计划(20210278)。

摘　　要：本研究探讨磁共振成像(MRI)表观扩散系数(ADC)直方图诊断子宫内膜癌及判断肿瘤浸润程度的价值。选取98例子宫内膜癌患者作为病例组、100例子宫黏膜下肌瘤患者作为对照组,两组患者均接受MRI检查,绘制MRI检查感兴趣区域的ADC直方图并进行对比,按照肿瘤浸润程度将98例子宫内膜癌患者进行分层分析。病例组患者的ADC平均值、ADC 10th、ADC 25th、ADC 50th、ADC 75th、ADC 95th测定值显著低于对照组患者(P<0.05);ADC 10th鉴别诊断子宫内膜癌与子宫黏膜下肌瘤的AUC为0.762;ADC 25th鉴别诊断子宫内膜癌与子宫黏膜下肌瘤的AUC为0.842。98例子宫内膜癌患者,其中58例患者子宫肌层浸润深度<1/2肌层,40例患者子宫肌层浸润深度≥1/2肌层。子宫肌层浸润深度<1/2肌层患者,其ADC平均值、ADC 10th、ADC 25th、ADC 50th测定值均显著高于浸润深度≥1/2肌层患者(P<0.05);ADC 10th鉴别诊断不同肌层浸润深度的子宫内膜癌患者的灵敏度为90.17%、特异度为72.80%、AUC为0.856。MRI ADC直方图参数对于鉴别诊断子宫内膜癌与子宫黏膜下肌瘤具有重要价值,术前采用MRI ADC直方图分析子宫内膜癌浸润深度具有重要意义。This study investigated the value of apparent diffusion coefficient(ADC) histogram of magnetic resonance imaging(MRI) in the diagnosis of endometrial cancer and the degree of tumor invasion. 98 patients with endometrial cancer were selected as the case group, and 100 patients with uterine submucosal fibroids were selected as the control group. Both the two groups of patients underwent MRI examination, and then drew and compared the ADC histogram of the interesting region in MRI. 98 patients with endometrial cancer were stratified according to the degree of tumor infiltrating. The average value of ADC, ADC 10 th, ADC 25 th, ADC 50 th, ADC 75 th and ADC 95 th in the case group were significantly lower than those in the control group(P<0.05). The AUC of ADC 10 th in the differential diagnosis of endometrial cancer and uterine submucosal fibroids was 0.762,and the AUC of ADC 25th in the differential diagnosis of endometrial cancer and uterine submucosal fibroids was 0.842.Among 98patients with endometrial cancer,58patients had myometrial infiltration depth<1/2myometrium,and 40patients had myometrial infiltration depth≥1/2myometrium.The mean value of ADC,measured value of ADC 10th,ADC 25th and ADC 50th in patients with myometrial infiltration depth<1/2 were significantly higher than those in patients with depth≥1/2 (P<0.05).The sensitivity of ADC 10th in differential diagnosis of endometrial carcer with different depth of myometrial invasion was 90.17%,the specificity was 72.80%,and the AUC value was 0.856.MRI ADC histogram parameters are of great value in the differential diagnosis of endometrial cancer and uterine submucosal fibroids.It has a great significance to analyze the depth of invasion of endometrial cancer by MRI ADC histogram before operation.

关 键 词：磁共振成像 表观扩散系数 直方图 子宫内膜癌 浸润 

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