子宫内膜纤维化的肌层和结合带形态及表观扩散系数值变化  

Changes of the morphology and apparent diffusion coefficient value for myometrium and junctional zone in endometrial fibrosis

作　　者：马可 朱慧 周楠 王欢欢[1] 姜佩佩[2] 胡清 冯永静 胡娅莉[2] 周正扬[1] MA Ke;ZHU Hui;ZHOU Nan;WANG Huanhuan;JIANG Peipei;HU Qing;FENG Yongjing;HU Yali;ZHOU Zhengyang(Department of Medical Imaging,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Medical Imaging,Nanjing Stomatological Hospital,the Affiliated Hospital of Nanjing University Medical School,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,江苏南京210008 [2]南京大学医学院附属鼓楼医院妇产科,江苏南京210008 [3]南京大学医学院附属口腔医院医学影像科,江苏南京210008

出　　处：《实用放射学杂志》2024年第8期1312-1315,共4页Journal of Practical Radiology

摘　　要：目的探讨子宫内膜纤维化患者子宫肌层厚度(MT)、肌层表观扩散系数值(ADCM)、结合带厚度(JZT)及结合带表观扩散系数值(ADCJZ)的变化。方法前瞻性纳入59例子宫内膜纤维化患者和34例健康育龄期女性(志愿者),测量子宫JZT、ADCJZ、MT及ADCM。利用独立样本t检验比较2组间JZT、ADCJZ、MT、ADCM差异。利用二元logistic回归分析建立联合预测模型(联合平均JZT、平均ADCJZ、平均MT)。利用受试者工作特征(ROC)曲线评估各参数平均值及联合预测模型对子宫内膜纤维化的诊断效能。结果子宫内膜纤维化患者的JZT(前壁、后壁、底壁和平均值的P值分别为0.007、0.035、0.001和<0.001)、ADCJZ(前壁、后壁、底壁和平均值的P值均<0.001)和MT(前壁、后壁和平均值的P值分别为0.003、<0.001和0.003)均显著大于志愿者。平均ADCJZ[曲线下面积(AUC)=0.872]和联合预测模型(AUC=0.953)对子宫内膜纤维化均具有较高诊断价值。结论MRI可以用于子宫内膜纤维化患者子宫肌层和JZ变化的无创评估。Objective To explore the changes of the thickness of myometrium(MT),apparent diffusion coefficient value of myometrium(ADCM),thickness of junctional zone(JZT)and apparent diffusion coefficient value of junctional zone(ADCJZ)in patients with endometrial fibrosis.Methods A total of 59 patients with endometrial fibrosis and 34 healthy women(volunteer)of childbearing age were prospectively included.The JZT,ADCJZ,MT and ADCM were measured.Independent samples t-test was used to compare the differences in JZT,ADCJZ,MT,and ADCM between the two groups.A combined prediction model was established using binary logistic regression analysis(combining mean JZT,mean ADCJZ,and mean MT).The efficiency of each parameter’s mean value and the combined prediction model in diagnosing endometrial fibrosis was evaluated using the receiver operating characteristic(ROC)curve.Results JZT(anterior wall,posterior wall,fundus and mean;P=0.007,0.035,0.001 and<0.001,respectively),ADCJZ(anterior wall,posterior wall,fundus and mean;all P<0.001)and MT(anterior wall,posterior wall and mean;P=0.003,<0.001 and 0.003,respectively)were significantly larger in patients with endometrial fibrosis compared to volunteer.Mean ADCJZ[area under the curve(AUC)=0.872]and the combined prediction model(AUC=0.953)had high value for diagnosing endometrial fibrosis.Conclusion MRI can be used for noninvasively assessing the changes of myometrium and JZ in patients with endometrial fibrosis.

关 键 词：磁共振成像 子宫内膜纤维化 子宫肌层 结合带 无创评估 

分 类 号：R445.2[医药卫生—影像医学与核医学] R711.74[医药卫生—诊断学]