动态增强MRI半定量信号强度-时间曲线及全定量灌注参数在子宫肿瘤中的应用

发布时间：2018-04-27 05:35

本文选题：子宫 + 新生物　；参考：《中南大学学报(医学版)》2015年12期

【摘要】：目的:探讨3.0T动态增强MRI半定量信号强度-时间(signal intensity-time,SI-Time)曲线及全定量灌注参数在子宫病变中的应用价值。方法:回顾性分析经病理证实为子宫恶性肿瘤20例,良性肿瘤或肿瘤样病变22例。均行3.0T动态增强MRI扫描,并使用Siemens Tissue 4D软件进行图像后处理,勾画感兴趣区并绘制SI-Time曲线。进一步测得感兴趣区的容积定量灌注参数值:容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)。对良、恶性病变组的SI-Time曲线类型进行统计学分析,对良、恶性病变组的定量灌注参数值进行单因素方差分析,多个样本均数的两两比较。结果:20例恶性肿瘤中宫颈癌12例,内膜癌8例;22例良性病变中13例为平滑肌瘤,3例为子宫内膜息肉,3例内膜增生,3例为子宫腺肌症。良性组以I型曲线(59.1%)为主;恶性组以II型曲线(65.0%)为主。不同类型的SI-Time曲线在良恶性病变之间差异具有统计学意义(P=0.011)。若以I型曲线作为诊断子宫良性病变的标准,II和III型曲线作为诊断子宫恶性病变的标准,则诊断灵敏度为90%,特异性为59.1%,阳性预测值为66.7%,阴性预测值为86.7%。恶性病变组Ve值比良性病变组[(0.477±0.143)vs(0.589±0.176),P=0.004]和对照组[(0.477±0.143)vs(0.614±0.146),P=0.004]均低;恶性病变组Ktrans值比对照组低[(0.178±0.067)min-1 vs(0.263±0.111)min-1,P=0.003];良性病变组Ktrans比对照组低[(0.182±0.096)min-1 vs(0.263±0.111)min-1,P=0.011]。结论:动态增强MRI半定量SI-Time曲线及全定量灌注参数值在子宫良恶性病变鉴别诊断中具有积极意义,可作为常规MRI形态学诊断的有效补充手段。
[Abstract]:Objective: to investigate the application value of 3.0T dynamic enhanced MRI semi-quantitative signal intensity-time signal SI-Timecurve and total quantitative perfusion parameters in uterine lesions. Methods: twenty cases of uterine malignant tumor and 22 cases of benign tumor or tumor-like lesion were analyzed retrospectively. 3.0T dynamic enhanced MRI scan was performed, and Siemens Tissue 4D software was used to post-process the image, draw the region of interest and draw the SI-Time curve. Furthermore, the volume quantitative perfusion parameters of the region of interest were determined as follows: volume transfer constant (KtransA), rate constant (Kepa), extracellular space volume ratio (ECV) and extracellular volume ratio (Veg). The SI-Time curve types of benign and malignant lesions were statistically analyzed, and the quantitative perfusion parameters of benign and malignant lesions were analyzed by single factor variance analysis. Results 12 cases of cervical carcinoma and 8 cases of endometrial carcinoma were benign lesions. 13 cases were leiomyoma, 3 cases were endometrial polyposis and 3 cases were adenomyosis. In the benign group, the type I curve was 59.1%, and the malignant group was the type II curve (65.0%). The difference of SI-Time curves between benign and malignant lesions was statistically significant. The sensitivity, specificity, positive predictive value, negative predictive value and negative predictive value were 90, 59.1, 66.7 and 86.7, respectively, if type I curve and III curve were used as criteria for the diagnosis of uterine benign lesions. The diagnostic sensitivity was 90, the specificity was 59.1, the positive predictive value was 66.7 and the negative predictive value was 86.7. The value of ve in malignant lesion group was lower than that in benign lesion group (0.477 卤0.176) and control group (0.477 卤0.146), Ktrans in malignant lesion group was lower than that in control group [0.178 卤0.067)min-1 vs(0.263 卤0.111 min-1P 0.003], Ktrans in benign lesion group was lower than that in control group [0.182 卤0.096)min-1 vs(0.263 卤0.111 min-1P 0.011]. Conclusion: dynamic enhanced MRI semi-quantitative SI-Time curve and total quantitative perfusion parameters have positive significance in the differential diagnosis of benign and malignant uterine lesions, and can be used as an effective supplementary method for conventional morphologic diagnosis of MRI.
【作者单位】：暨南大学附属第一医院放射科;广州市第一人民医院放射科;
【分类号】：R445.2;R737.33

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