3.0T MR动态增强成像对宫腔良恶性占位病变的鉴别诊断价值

发布时间：2018-02-28 16:43

本文关键词： 子宫内膜癌良性子宫内膜占位磁共振成像动态增强成像　出处：《中国医学计算机成像杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨动态增强MR(DCE-MRI)对宫腔良恶性占位病变的鉴别诊断价值。方法:经病理证实的子宫内膜癌32例、宫腔良性占位病变30例行常规MRI和DCE-MRI检查。使用卡方检验比较良恶性病变的形态学特征、TIC曲线差别。使用独立样本t检验比较DCE-MRI半定量参数:包括强化峰值(SImax)、达峰时间(TTP)、最大相对强化度(SIpeak%)及流出分数(washout),对各参数进行ROC曲线分析以寻求最佳参数及最佳诊断阈值。结果:子宫内膜癌与良性病变的形态学特征(结合带除外)没有统计学差异。子宫内膜癌与良性病变的TIC曲线有统计学差异。良性病变多出现I型曲线,子宫内膜癌多出现Ⅲ型曲线。子宫内膜良恶性病变间各DCE-MRI参数差异均存在统计学意义。ROC曲线分析结果显示TTP与流出分数具有较好的诊断效能。TTP的曲线下面积AUC=0.827,当阈值设为154时,敏感度为81.3%,特异性为76.7%;流出分数的曲线下面积AUC=0.808,当阈值设为0.0853时,敏感度为75.0%,特异性为80.0%。结论:3.0T MR动态增强成像有助于鉴别子宫内膜癌与其他宫腔良性占位病变;在动态增强MR四个参数中TTP和流出分数具有较好的诊断效能。
[Abstract]:Objective: to evaluate the value of dynamic contrast enhanced MRCE-MRI in the differential diagnosis of benign and malignant space-occupying lesions in uterine cavity. Routine MRI and DCE-MRI examinations were performed in 30 cases of benign space occupying lesions in uterine cavity. The morphological features of benign and malignant lesions were compared by chi-square test. The semi-quantitative parameters of DCE-MRI were compared by independent sample t-test, including enhancement peak value SI-maxus, up to and including enhancement peak. ROC curve analysis was performed to find the best parameters and the best diagnostic threshold. Results: morphological features of endometrial carcinoma and benign lesions (except the conjunctive band) were analyzed by ROC curve. There is no statistical difference. The TIC curve of endometrial carcinoma is statistically different from that of benign lesions. The difference of DCE-MRI parameters between benign and malignant endometrial lesions was statistically significant. The results of ROC curve analysis showed that the area under the curve of TTP and outflow fraction was better. When the threshold value was set to 154, the area under the curve of TTP and outflow fraction was better. The sensitivity is 81.3 and the specificity is 76.7.The area under the curve of outflow fraction is 0.808, when the threshold is 0.0853, the sensitivity is 75.0 and the specificity is 80.0.Conclusion the dynamic contrast enhanced Mr imaging at 30: 3.0 T is helpful to distinguish endometrial carcinoma from other benign space occupying lesions in uterine cavity. Among the four parameters of dynamic enhanced Mr, TTP and outflow fraction have better diagnostic efficiency.
【作者单位】：上海交通大学医学院附属瑞金医院北院放射科;
【分类号】：R445.2;R737.33

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