【摘要】 目的 比较单、双指数模型参数在术前子宫内膜癌肌层浸润中的应用价值。方法 对35例子宫内膜癌患者行单指数模型(b=0,800 s/mm~2)及双指数模型扩散加权成像(DWI)检查(b=0、50、100、150、200、400、600、800、1 000、1 200、1 500 s/mm~2),其中深肌层浸润组14例,非深肌层浸润组21例。利用Matlab软件测量表观扩散系数(ADC)值、纯扩散系数(D)值、灌注相关扩散系数(D~*)值及灌注分数(f)值,比较2组之间的参数是否有统计学差异,并分析诊断效能。结果 子宫内膜癌深肌层浸润组的D值(P<0.001)及ADC值(P<0.001)均低于非浸润组,差异有统计学意义。2组之间f值(P=0.600)与D~*值(P=0.600)无显著差异。ADC值及D值对于鉴别子宫内膜癌深肌层浸润的曲线下面积(AUC)分别为0.913及0.969。根据Youden指数确定最佳诊断切点值,ADC值及D值鉴别诊断子宫内膜癌深肌层浸润的敏感度分别为90.48%及100%,特异性均为85.71%。结论 单指数模型的参数ADC值和双指数模型的参数D值均有助于评估子宫内膜癌深肌层浸润,双指数模型DWI的参数D值诊断效能更大。更多还原

【Abstract】 Objective To compare the value of mono exponential and biexponential models in the preoperative evaluation of myometrial invasion in endometrial carcinoma.Methods 35 cases of endometrial carcinoma were examined by diffusion weighted imaging(DWI)with mono exponential model(b=0,800 s/mm~2) and biexponential model(b=0,50,100,150,200,400,600,800,1 000,1 200,and1 500 s/mm~2),including 14 cases of deep myometrial invasion and 21 cases of non-deep myometrial invasion.The values of apparent diffusion coefficient(ADC),pure diffusion coefficient,perfusion related diffusion coefficient and the microvascular volume fraction were measured by the Matlab software.These parameters of two groups were compared and analyzed,respectively.Results The D value and the ADC value in the deep myometrial invasion group of endometrial carcinoma were lower than those in the non-deep myometrial invasion group,and the differences were statistically significant(both P<0.001).There was no significant difference between the two groups in the f value(P=0.600) and D~* value(P=0.600).The AUC of ADC value and D value for the differential diagnosis of endometrial carcinoma with and without deep myometrial invasion were 0.913 and 0.969,respectively.Based on the Youden index and its corresponding optimal cut-point,the sensitivity of ADC value and D value were 90.48% and 100%,respectively,and the specificity of ADC value and D value were both 85.71 % in differential diagnosis of endometrial carcinoma with and without deep myometrial invasion.Conclusion The ADC value in mono exponential model and the D value in biexponential model can be both used to evaluate deep myometrial invasion of endometrial carcinoma,among which D value is better.更多还原