摘要
目的探讨动态增强磁共振成像(DCE-MRI)和体素内不相干运动成像(IVIM)鉴别正常子宫内膜、子宫内膜息肉(EP)和早期(I期)子宫内膜癌(EC)的价值。资料与方法回顾性收集2021年1月—2022年1月新乡医学院第一附属医院行盆腔MRI检查的20例正常子宫内膜、17例EP和30例早期EC,分别测量DCE-MRI参数容积转移常数(Ktrans)、速率常数(Kep)和血管外细胞外容积分数(Ve),以及IVIM参数真性扩散系数(D)、假性扩散系数(D*)和灌注分数(f)。比较不同组间各参数的差异,采用受试者工作特征曲线评估各参数的诊断效能,采用Logistic回归分析进行多参数联合诊断,评价不同参数间的相关性。结果EP组的Ktrans(t=-3.347,P=0.002)和Kep(Z=-1.981,P=0.048)高于正常组,EC组的Ktrans(t=-4.316、-2.447,P均<0.05)和Kep(Z=-5.248、-4.650,P均<0.05)均高于正常组和EP组,D(t=2.884、2.941,P均<0.01)、f(t=3.100、2.874,P均<0.01)和Ve(t=3.846、4.288,P均<0.01)均低于正常组和EP组。DCE-MRI、Ktrans和Kep鉴别正常子宫内膜和EP的曲线下面积分别为0.735、0.732、0.691。DCE-MRI、IVIM、Kep、Ve、D、f和Ktrans鉴别EP和EC的曲线下面积分别为0.920、0.841、0.912、0.820、0.764、0.686、0.682。DCE-MRI、IVIM、Kep、Ktrans、Ve、D和f鉴别EC和正常子宫内膜的曲线下面积分别为0.958、0.867、0.942、0.850、0.762、0.709、0.699。D与Ktrans和Kep均呈负相关(r=-0.251、-0.270,P均<0.05),f与Ktrans和Kep均呈负相关(r=-0.289、-0.360,P均<0.05)。结论DCE-MRI和IVIM鉴别EC与EP有类似的效能,且部分参数之间存在一定的相关性。
Purpose To explore the value of intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differentiation of normal endometrium,endometrial polyp(EP)and early-stage(stage I)endometrial carcinoma(EC).Materials and Methods Twenty subjects with normal endometrium,17 patients with EP and 30 patients with early-stage EC who underwent pelvic MRI from January 2021 to January 2022 in the First Affiliated Hospital of Xinxiang Medical University were retrospectively collected.Moreover,the DCE-MRI parameters,including volume transfer constant(Ktrans),rate transfer constant(Kep)and volume of extravascular extracellular space per unit volume of tissue(Ve);and IVIM parameters,including diffusion coefficient(D),pseudo diffusion coefficient(D*)and perfusion fraction(f)were measured and compared,respectively among three groups.Receiver operating characteristic curve was used to evaluate the diagnostic performance of each parameter,respectively.Logistic regression analysis was used for the combined diagnosis of different parameters,and the correlation between different parameters with each other was also evaluated.Results Ktrans(t=-3.347,P=0.002)and Kep(Z=-1.981,P=0.048)in EP group were significantly higher than those in normal group.Ktrans(t=-4.316,-2.447,both P<0.05)and Kep(Z=-5.248,-4.650,P<0.05)in EC group were significantly higher than those in normal group and EP group.D(t=2.884,2.941,P<0.01),f(t=3.100,2.874,P<0.01)and Ve(t=3.846,4.288,P<0.001)in EC group were significantly lower than those in normal group and EP group.For normal and EP groups,area under the curve of DCE-MRI,Ktransand Kepwere 0.735,0.732 and 0.691,respectively.For EP and EC groups,the area under the curve of DCE-MRI,IVIM,Kep,Ve,D,f and Ktranswere 0.920,0.841,0.912,0.820,0.764,0.686 and 0.682,respectively.For normal and EC groups,the area under the curve of DCE-MRI,IVIM,Kep,Ktrans,Ve,D and f were0.958,0.867,0.942,0.850,0.762,0.709 and 0.699,respectively.D showed low negative correlation with Ktransand Kep(r=-0.251,-0.270,P<0.05),f showed low negative correlation with Ktransand Kep(r=-0.289,-0.360,P<0.05).Conclusion DCE-MRI and IVIM have similar efficacy in EC and EP identification,with some correlations between some parameters.
作者
刘旺毅
闫瑞芳
任继鹏
王红霞
谢北辰
韩东明
LIU Wangyi;YAN Ruifang;REN Jipeng;WANG Hongxia;XIE Beichen;HAN Dongming(Department of Magnetic Resonance,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第1期65-71,共7页
Chinese Journal of Medical Imaging
基金
伦琴影像科研专项(HN-20201017-002)。
关键词
子宫内膜肿瘤
子宫内膜息肉
磁共振成像
体素内不相干运动成像
诊断
鉴别
Endometrial neoplasms
Endometrial polyp
Magnetic resonance imaging
Intravoxel incoherent motion
Diagnosis
differential
