摘要
[目的]探讨基于表观扩散系数(apparent diffusion coefficient,ADC)值的全域直方图参数鉴别子宫内膜癌(endometrial cancer,EC)和宫腔内良性病变的价值。[方法]回顾性分析经手术病理证实的宫腔内病变患者179例,其中EC 78例,宫腔内良性病变101例。术前2周内均行盆腔磁共振成像和弥散加权成像。采用Mann-Whitney U检验或两独立样本t检验比较EC组和宫腔内良性病变组的ADC直方图参数。绘制直方图参数的受试者工作特性(receiver operating characteristic,ROC)曲线。不同特征的ROC曲线的比较采用德龙检验。通过多因素Logistic回归筛选出宫腔内良恶性病变的独立预测因子。[结果]在EC和宫腔内良性病变的全域直方图参数分析中,EC组全肿瘤直方图分析的灰度值的最大值、最小值、平均值、中位数、P_(10)、P_(25)、P_(50)、P_(75)、P_(90)、均匀性均显著性低于宫腔内良性病变组。能量、熵、峰度、偏度明显高于宫腔内良性病变组(P值均<0.05)。多因素Logistic回归分析筛选出年龄(OR=1.182,P<0.05)和直方图得分(OR=1.081,P<0.001)为宫腔内良恶性病变的独立预测因子。[结论]基于ADC的全域直方图分析有助于子宫内膜癌与宫腔内良性病变的鉴别。
[Objective]To explore the value of global histogram parameters of MRI apparent diffusion coefficient(ADC)in distinguishing endometrial cancer(EC)from benign intrauterine lesions.[Methods]A total of 179 patients with intrauterine lesions confirmed by surgery and pathology were enrolled in the study,including 78 cases of EC and 101 cases of benign intrauterine lesions.Pelvic MRI and diffusion weighted imaging were performed within 2 weeks before surgery.Mann-Whitney U test or independent sample t test was used to compare the ADC histogram parameters of the EC group and the benign group.The receiver operating characteristic(ROC)curve of histogram parameters were analyzed to calculate the sensitivity and specificity.The ROC curves with different characteristics were compared by Delong test.Independent predictors of benign and malignant lesions in uterine cavity were screened by multivariate Logistic regression.[Results]The maximum,minimum,average,median,10^(th)percentile,25^(th)percentile,50^(th)percentile,75^(th)percentile,90^(th)percentile,and uniformity of EC group were significantly lower than those of the benign group.Energy,entropy,kurtosis,and skewness of EC group were significantly higher than those in the benign group(all P<0.05).Multivariate Logistic regression analysis showed that age(OR=1.182,95%CI:1.061~1.316,P<0.05)and histogram score(OR=1.081,95%CI:1.054~1.110,P<0.001)were independent predictors of benign and malignant uterine lesions.[Conclusion]The global histogram analysis of ADC value is helpful to distinguish endometrial cancer from benign intrauterine lesions.
作者
夏阳
赵振华
黄亚男
毛海佳
韦明珠
李丽
孙军辉
XIA Yang;ZHAO Zhen-hua;HUANG Ya-nan;MAO Hai-jia;WEI Ming-zhu;LI Li;SUN Jun-hui(The First Affiliated Hospital of Medical College of Zhejiang University,Hangzhou 310003,China;Shuoxing Muernal and Child Health Hospital,shaoxing 312000,China;Shaoxing Hospital of Zhejiang University(Shaoxing People's Hospital),Shaoxing 312000,China)
出处
《肿瘤学杂志》
CAS
2021年第3期212-216,共5页
Journal of Chinese Oncology
基金
浙江省医药卫生科技计划项目(2015KYB402)。
关键词
子宫内膜肿瘤
表观扩散系数
直方图
鉴别诊断
endometrial neoplasms
apparent diffusion coefficient
histogram
differential diagnosis
