摘要
目的评估单指数、双指数、拉伸指数模型各参数在子宫内膜癌诊断及病理分级中的价值。方法搜集简单性、复杂性及非典型增生内膜18例,高(G1)、中(G2)、低(G3)分化子宫内膜癌患者43例,并纳入健康志愿者20例作为对照组,行常规MRI和多b值DWI扫描,在各参数伪彩图上测量表观扩散系数(ADC)、真扩散系数(D)、假扩散系数(D~*)、灌注分数(f)、分布扩散系数(DDC)、水扩散异质性指数(α)值。使用方差分析、秩和检验在正常组、癌前病变组、G1、G2、G3组间两两进行差异性比较。绘制受试者工作特征(ROC)曲线,评价各参数对子宫内膜癌诊断及病理分级的效能。结果 5组间两两比较,D、DDC值差异均有统计学意义(P<0.05),D~*值差异均无统计学意义(P>0.05);G2组与G3组间f、α、ADC值差异无统计学意义(P>0.05),G2组与G1组间α值差异无统计学意义(P>0.05),余组间f、α、ADC值差异均有统计学意义(P<0.05)。D、DDC、ADC、f、α、D~*值诊断子宫内膜癌的ROC曲线下面积分别为:0.95、0.98、0.93、0.93、0.89、0.68,判断病理分级的曲线下面积分别为:0.96、0.90、0.89、0.80、0.65、0.52。结论单指数模型对诊断子宫内膜癌及判断病理分级有一定帮助,双指数、拉伸指数模型较之价值更高。
Objective To evaluate the value of monoexponential,biexponential,and stretched exponential diffusion-weighted imaging models in the diagnosis and pathological grade of endometrial cancer. Methods This study included 18 cases of simple, complex and atypical hyperplasia endometrium and 43 cases of endometrial cancer. Endometrial cancer patients are divided into three groups according to pathological grade(G1,G2,G3). There were 20 healthy people without gynecological disease history as a control group. All patients underwent routine MRI and multi-b-value DWI scans. Measurement of apparent diffusion coefficient(ADC),true diffusion coefficient(D),pseudo-diffusion coefficient(D~*),perfusion fraction(f),distribution diffusion coefficient(DDC),water molecular diffusion heterogeneity index(α) on pseudo-color map value, was done. Difference analysis was performed between the normal group,precancerous lesion group,G1,G2,and G3 groups using variance analysis and rank sum test. The receiver operating characteristic(ROC) curve was plotted to evaluate the efficacy of each parameter in the diagnosis and pathological grading of endometrial cancer. Results There were significant differences in D and DDC between the five groups(P<0.05).ADC:Except for the difference between G2 group and G3 group(P>0.05),the difference between the other groups was statistically significant(P<0.05).f:There was no significant difference between the G2 group and the G3 group(P>0.05),and the difference between the other groups was statistically significant(P<0.05).α:There was no significant difference between the G2 group and the G1 group and the G3 group and the G2 group(P>0.05),the difference between the other groups was statistically significant(P<0.05).There was no significant difference in D~* between the five groups(P>0.05).The areas under the ROC curve of D,DDC,ADC,f,α and D~* diagnosed endometrial cancer were 0.95,0.98,0.93,0.93,0.89,0.68. The areas under the curve for judging pathological grade were 0.96,0.90,0.89,0.80,0.65,0.52. Conclusion T
作者
尹希
吴慧
高阳
乔鹏飞
牛广明
YIN Xi;WU Hui;GAYang(Department of MRI,First Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第10期1904-1908,共5页
Journal of Clinical Radiology
关键词
磁共振成像
子宫内膜癌
诊断
病理分级
Magnetic resonance imaging
Endometrial cancer
Diagnosis
Pathological grading
