摘要
目的:探讨磁共振扩散加权成像(DWI)评估子宫内膜癌淋巴血管间隙侵犯(LVSI)的价值。方法:回顾性分析97例经病理证实的子宫内膜癌患者的临床及影像资料,测量其表观扩散系数(ADC)值。将97例患者分为LVSI(+)组31例与LVSI(-)组66例,比较两组患者最小ADC值(ADCmin)、平均ADC值(ADCmean)、最大ADC值(ADCmax)的差异,并绘制受试者工作特性(ROC)曲线评估各ADC值对子宫内膜癌LVSI的诊断价值。结果:两组患者的ADCmax值差异无统计学意义(P>0.05);LVSI(+)组与LVSI(-)组患者的ADCmin值分别为(0.82±0.12)×10^-3mm^2/s和(1.01±0.14)×10^-3mm^2/s,ADCmean值分别为(1.04±0.16)×10^-3mm^2/s和(1.17±0.14)×10-3 mm 2/s,差异均有统计学意义(P值均<0.001)。以ADCmin取0.90×10^-3mm^2/s作为最佳诊断阈值时,对应的曲线下面积、敏感度、特异度、诊断符合率分别为0.88、80.65%、83.33%、82.47%;以ADCmean取1.06×10^-3mm^2/s作为最佳诊断阈值时,对应的曲线下面积、敏感度、特异度、诊断符合率分别为0.76、77.42%、78.79%、72.35%。ADCmin对LVSI的诊断效能优于ADCmean(Z=2.71,P=0.007)。结论:ADC值对评估子宫内膜癌LVSI具有一定价值,其中ADCmin的诊断效能更优。
Objective:To investigate the value of diffusion-weighted imaging(DWI)in evaluating lymphovascular space invasion(LVSI)of endometrial cancer.Methods:The clinical and imaging data of 97 patients with pathologically confirmed endometrial cancer were retrospectively analyzed.They were divided into LVSI(+)group(n=31)and LVSI(-)group(n=66).The apparent diffusion coefficient(ADC)values,including minimum ADC value(ADCmin),mean ADC value(ADCmean)and maximum ADC value(ADCmax),were measured.The ADCmin,ADCmean and ADCmax were compared between the two groups.The diagnostic performance of ADC values for differentiation of LVSI was determined by receiver operating characteristic curve(ROC).Results:There was no significant difference in ADCmax between the two groups(P>0.05).The ADCmin values of LVSI(+)group and LVSI(-)group were(0.82±0.12)×10^-3mm^2/s and(1.01±0.14)×10^-3mm^2/s,respectively,and the ADCmean values were(1.04±0.16)×10^-3mm^2/s and(1.17±0.14)×10^-3mm^2/s,respectively,with significant differences(all P<0.001).With the threshold of 0.90×10^-3mm^2/s for ADCmin,the corresponding area under ROC(AUROC),sensitivity,specificity and accuracy were 0.88,80.65%,83.33%and 82.47%,respectively.With the threshold of 1.06×10^-3mm^2/s for ADCmean,the AUROC,sensitivity,specificity and accuracy were 0.76,77.42%,78.79%and 72.35%,respectively.The diagnostic performance of ADCmin for LVSI(+)was better than that of ADCmean(Z=2.704,P=0.007).Conclusion:ADCmin may be valuable for differentiation of LVSI of endometrial cancer.
作者
漆万银
程勇
杨述根
QI Wan-yin;CHENG Yong;YANG Shu-gen(Department of Radiology,the Affiliated Hospital of Southwest Medical University,Sichuan 646000,China)
出处
《放射学实践》
CSCD
北大核心
2021年第2期222-226,共5页
Radiologic Practice
关键词
扩散加权成像
磁共振成像
子宫内膜癌
淋巴血管间隙侵犯
Diffusion weighted imaging
Magnetic resonance imaging
Endometrial cancer
Lymphovascular space invasion
