摘要
目的:探讨磁共振成像(MRI)中联合带厚度指标和病灶区T_2WI高信号灶联合应用对子宫腺肌症的诊断价值。方法:回顾性分析56例经手术和病理证实为子宫腺肌症患者及35例正常对照组的MRI资料,在观察子宫腺肌症MRI病灶特征的基础上,测量联合带厚度最大值(JZ_(max))、最大值与最小值差(JZ_(dif))、联合带与肌层厚度比(JZ_(rat))。子宫腺肌症组和对照组JZ_(max)、JZ_(dif)、JZ_(rat)比较采用Mann-Whitney U检验。联合带增厚和高信号灶单独应用与联合应用诊断子宫腺肌症的差异采用Pearsonχ2检验。结果:弥漫性子宫腺肌症35例,局限性21例。弥漫性子宫腺肌症中,3例联合带测量困难;另外32例中,JZ_(max)、JZ_(dif)和JZ_(rat)三者平均值分别为20.6mm、12.8mm和70.1%。局限性子宫腺肌症中,3例联合带显示欠清,其他18例JZ_(max)、JZ_(dif)和JZ_(rat)平均值分别为16.4mm、10.2mm和61.0%。子宫腺肌症组和正常对照组JZ差异有统计学意义(P<0.05)。子宫腺肌症48例(85.7%)见T_2WI高信号灶。JZ_(max)、JZ_(dif)和T_2WI高信号3个参数联合应用诊断子宫腺肌症的灵敏度、特异度和准确度分别为92.9%、97.1%、94.5%,其中敏感度和准确度高于JZ_(max)、JZ_(dif)单独应用(P<0.05)。结论:JZ_(max)、JZ_(dif)、JZ_(rat)联合T_2WI高信号有助于提高子宫腺肌症诊断价值。
Objective：To explore the diagnostic value of combined j unctional zone thickness indices and intralesional T2-hyperintense foci in magnetic resonance imaging （MRI）in the diagnosis of adenomyosis.Methods：MRI data of 56 patients with adenomyosis confirmed by surgery and pathology and 35 cases in the control group were retrospectively analyzed.On the basis of observing the characteristics of MRI lesions of adenomyosis,the maximum junctional zone thickness （JZmax ）,the j unctional zone difference between the maximum and the minimum （JZdif ）,and the thickness ratio of j unctional zone to myometrium （JZrat）were measured.JZmax,JZdif,and JZrat were compared between the two groups with Mann-WhitneyU test. Pearson chi-square test was used to compare the differences between j unctional zone,T2-hyperintense foci and combined application of the two in the diagnosis of adenomyosis.Results：Thirty-five cases were diffuse adenomyosis and 21 cases were focal adenomyosis.Among 35 cases with diffuse adenomyosis,the junctional zone could not be well visualized and measured in 3 cases;the average JZmax,JZdif,and JZrat of the remaining 32 cases were 20.6 mm,12.8 mm,and 70.1%,respectively. Among 21 cases with focal adenomyosis,the junctional zone could not be well visualized and measured in 3 cases;the average JZmax,JZdif,and JZrat of the remaining 18 cases were 16.4 mm,10.2 mm,and 61.0%,respectively.There were significant differences in JZmax,JZdif,and JZrat between the adenomyosis group and the control group.Forty-eight （85.7%）of 56 cases in the adenomyosis group had T2-hyperintense foci.The combined sensitivity,specificity and accuracy of JZmax ,JZdif ,and T2-hyperintense foci were 92.9%,97.1%,and 94.5%,respectively,and the sensitivity and accuracy were higher than those of individual diagnoses of JZmax and JZdif（P〈0.05）.Conclusions：JZmax,JZdif,JZrat and intralesional T2-hyperintense foci are all valuable in the diagnosis of uterine adenomyosis,and combination of JZmax ,JZdif and intralesional T2-hyp
出处
《中国临床医学》
2017年第1期37-42,共6页
Chinese Journal of Clinical Medicine
基金
上海市医学重点建设专科(ZK2015A05)
上海市金山区科委科学技术创新项目(2012-3-01)~~
关键词
子宫腺肌症
磁共振成像
联合带
adenomyosis
magnetic resonance imaging
junctional zone
