子宫形态学及内膜T_(2)信号强度对内膜损伤后纤维修复的分度评估  

Changes of uterine morphology and endometrial T_(2) signal intensity in the fibrotic repair secondary to endometrial injury

作　　者：周楠 朱慧 马可 姜佩佩[2] 胡清 冯永静 胡娅莉 周正扬[1] Zhou Nan;Zhu Hui;Ma Ke;Jiang Peipei;Hu Qing;Feng Yongjing;Hu Yali;Zhou Zhengyang(Department of Radiology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China;Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China;Department of Radiology,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,南京210008 [2]南京大学医学院附属鼓楼医院妇产科,南京210008 [3]南京大学医学院附属口腔医院医学影像科,南京210008

出　　处：《中华妇产科杂志》2023年第11期826-832,共7页Chinese Journal of Obstetrics and Gynecology

基　　金：中国科学院战略性先导科技专项(XDA16040302)。

摘　　要：目的探讨子宫形态学参数及内膜T_(2)信号强度(T_(2)-SI)对内膜损伤后纤维修复分度评估的价值。方法从2018年9月至2023年2月,在南京大学医学院附属鼓楼医院前瞻性纳入重度子宫内膜损伤后纤维修复患者29例(重度组)、轻中度子宫内膜损伤后纤维修复患者17例(轻中度组)和健康育龄期妇女40例(健康对照组)。所有观察对象行磁共振成像检查,并测量宫腔长度(LUC)、子宫颈及峡部长度(LCI)、宫腔上端宽度(WUUC)和宫腔下端宽度(WLUC);另测量子宫内膜T_(2)-SI,以臀部皮下脂肪T_(2)-SI作为参照,计算子宫内膜T_(2)-SI/臀部皮下脂肪T_(2)-SI比值即为子宫内膜标准化T_(2)-SI(nT_(2)-SI)。采用单因素方差分析、Mann-Whitney U检验、组内相关系数、Spearman rho检验、受试者工作特征曲线及其曲线下面积(AUC)等方法对数据进行统计学分析。结果重度组患者的LUC、WUUC、WLUC、内膜nT_(2)-SI[分别为(19.7±3.5)mm、(26.9±6.4)mm、(7.9±1.4)mm、0.73±0.11]均显著小于健康对照组(P均<0.01),而LCI及WUUC/LUC比值[分别为(51.3±7.3)mm、1.38±0.34]均显著大于健康对照组(P均<0.001)。重度组的LUC及WLUC均显著小于轻中度组[分别为(32.4±5.1)mm、(8.8±1.2)mm],分别比较,差异均有统计学意义(P均<0.05);而LCI及WUUC/LUC比值均显著大于轻中度组[分别为(41.8±8.6)mm、0.94±0.16],分别比较,差异均有统计学意义(P均<0.001)。轻中度组患者的LUC及内膜nT_(2)-SI(0.68±0.13)均显著小于健康对照组[分别为(35.3±3.5)mm、0.80±0.12],分别比较,差异均有统计学意义(P均<0.01)。LUC、WUUC、WLUC及内膜nT_(2)-SI与内膜损伤后纤维修复分度等级均呈显著负相关(Spearman rho值分别为-0.794、-0.441、-0.471和-0.316,P均<0.05),而LCI及WUUC/LUC比值与内膜损伤后纤维修复分度等级均呈显著正相关(Spearman rho值分别为0.481和0.674,P均<0.05)。LUC及WUUC/LUC比值在区分重度组与健康对照组或轻中度组中具有较高�Objective To investigate the value of uterine morphological parameters and endometrial T_(2) signal intensity(T_(2)-SI)in evaluating the degree of the fibrotic repair secondary to endometrial injury.Methods From Sep.2018 to Feb.2023,this study prospectively enrolled 29 patients with fibrotic repair secondary to severe endometrial injury(severe group),17 patients with fibrotic repair secondary to mild to moderate endometrial injury(mild to moderate group),and 40 healthy women of reproductive age(control group)in Nanjing Drum Tower Hospital.The length of uterine cavity(LUC),length of cervix and isthmus(LCI),width of upper uterine cavity(WUUC)and width of lower uterine cavity(WLUC)were measured using magnetic resonance imaging.T_(2)-SI of endometrium and subcutaneous fat of buttocks were measured,and endometrial normalized T_(2)-SI(nT_(2)-SI;T_(2)-SI of endometrium/T_(2)-SI of subcutaneous fat of buttocks)was calculated.Statistical analyses of data were performed using one-way analysis of variance,Mann-Whitney U test,intraclass correlation coefficient,Spearman rho test,area under the receiver operating characteristic curve(AUC).Results LUC,WUUC,WLUC and endometrial nT_(2)-SI of severe group[(19.7±3.5)mm,(26.9±6.4)mm,(7.9±1.4)mm,0.73±0.11,respectively]were significantly lower than those of the control group(all P<0.01),while LCI and WUUC/LUC[(51.3±7.3)mm and 1.38±0.34]were significantly higher than those of the control group(all P<0.001).LUC and WLUC of severe group were significantly lower than those of mild to moderate group[(32.4±5.1)mm and(8.8±1.2)mm;all P<0.05],while LCI and WUUC/LUC were significantly higher than those of mild to moderate group[(41.8±8.6)mm and 0.94±0.16;all P<0.001].LUC and endometrial nT_(2)-SI of mild to moderate group were significantly lower than those of the control group[(32.4±5.1)vs(35.3±3.5)mm,0.68±0.13 vs 0.80±0.12;all P<0.01].LUC,WUUC,WLUC and endometrial nT_(2)-SI were significantly negatively correlated to the degree of the fibrotic repair secondary to endometrial inj

关 键 词：子宫内膜 再生 磁共振成像 评价研究(主题) 

分 类 号：R711.74[医药卫生—妇产科学]