摘要
目的 :通过研究增强T_2~*加权血管成像(ESWAN)序列的R_2~*值与子宫内膜癌(Endometrial carcinoma,EC)病理类型、肌层浸润深度、脉管浸润、侵犯转移的关系,探讨EC的生物学行为。方法:回顾性分析122例行1.5T MRI检查(含ESWAN序列),经手术病理诊断为EC的影像资料,测量EC病灶的R_2~*值。将所有患者分别分为4个配对组,即高风险病理类型组(Ⅰ型癌G3级与Ⅱ型癌,A1组)与低风险病理类型组(Ⅰ型癌G1、G2级,B1组),深肌层浸润组(A2组)与非深肌层浸润组(B2组),脉管浸润组(A3组)与非脉管浸润组(B3组),侵犯转移组(Ⅱ、Ⅲ、Ⅳ期,A4组)与非侵犯转移组(Ⅰ期,B4组)。采用独立样本t检验比较各配对组R_2~*值的差异;根据ROC曲线下面积(AUC)评估R_2~*值对EC高风险病理类型、深肌层浸润、脉管浸润、侵犯转移的诊断效能,找出相应界值。结果:A1组40例,B1组82例;A2组44例,B2组78例;A3组25例,B3组97例;A4组27例,B4组95例。4个配对组的R_2~*值分别为(17.60±4.02) Hz vs.(12.81±2.66) Hz,(17.57±3.96) Hz vs.(12.58±2.40) Hz,(18.62±4.68) Hz vs.(13.29±2.75) Hz,(18.33±4.22) Hz vs.(13.26±2.94) Hz,差异均具有统计学意义(t=6.840、7.613、5.456、5.858,P<0.001)。R_2~*值对EC高风险病理类型、深肌层浸润、脉管浸润、侵犯转移的AUC分别为0.856、0.876、0.834、0.855,预估EC高风险病理类型、深肌层浸润、脉管浸润、侵犯转移的界值分别为R_2~*值≥15.24 Hz、R_2~*值≥14.76 Hz、R_2~*值≥14.67 Hz、R_2~*值≥15.25 Hz,灵敏度分别为77.50%、82.90%,79.50%、79.50%,特异度分别为84.00%、68.00%,85.20%、76.80%。结论:R_2~*值可作为MR非强化方式评估EC生物学行为的定量指标。
Objective: To explore the biological behavior of endometrial carcinoma(EC) by analysing the correlation between the R2* value of enhanced T2 star-weighted angiography(ESWAN) sequence and the pathological type, depth of myometrium infiltration, vascular invasion, invasion and metastasis of EC. Methods: We retrospectively analyzed the imaging data of 122 cases who were diagnosed as EC by postoperative pathology and underwent 1.5 T MRI examination(including ESWAN sequence). The R2* values of EC lesions were measured. All patients were divided into four pairing groups: the high-risk pathological type group(type Ⅰ grade 3 and type Ⅱ, group A1) and low-risk pathological type group(type Ⅰ grade 1 and grade 2, group B1), deep myometrial invasion group(group A2) and non deep myometrial invasion group(group B2), vascular invasion group(group A3) and non vascular invasion group(group B3), invasion and metastasis group(stage Ⅱ, Ⅲ and Ⅳ, group A4) and non invasion and metastasis group(stage Ⅰ, group B4). The R2* values of the paired groups were compared by independent sample t test. The diagnostic efficiency of R2* in the diagnosis of EC high-risk pathological type, deep myometrial invasion, vascular invasion, invasion and metastasis was evaluated by receiver operator characteristic(ROC) curve, and the corresponding thresholds were found. Results: There were 40 cases in group A1, 82 cases in group B1, 44 cases in group A2,78 cases in group B2, 25 cases in group A3, 97 cases in group B3, 27 cases in group A4 and 95 cases in group B4. The R2* values of the four pairing groups were(17.60±4.02) vs.(12.81±2.66) Hz,(17.57±3.96) vs.(12.58±2.40) Hz,(18.62±4.68) vs.(13.29±2.75) Hz,(18.33±4.22) vs.(13.26±2.94) Hz, respectively, and the differences had statistically significant(t=6.840, 7.613,5.456, 5.858, P<0.001). The AUC of R2* values for EC high-risk pathological type, deep myometrial invasion, vascular invasion, invasion and metastasis were 0.856, 0.876, 0.834 and 0.855, respectively. The thresholds for predic
作者
田士峰
刘爱连
宋清伟
刘静红
孙美玉
朱雯
TIAN Shi-feng;LIU Ai-lian;SONG Qing-wei;LIU Jing-hong;SUN Mei-yu;ZHU Wen(The First Affiliated Hospital of Dalian Medical University,Dalian Liaoning 116011,China)
出处
《中国临床医学影像杂志》
CAS
2019年第2期126-130,共5页
Journal of China Clinic Medical Imaging
基金
首都科技领军人才培养工程(Z181100006318003)
关键词
子宫内膜肿瘤
磁共振成像
Endometrial neoplasms
Magnetic resonance imaging
