论文部分内容阅读
目的探讨DWI不同表观扩散系数评估子宫内膜良、恶性病变及子宫内膜样腺癌分化级别的价值,寻找鉴别子宫内膜良恶性病变的最佳ADC值。方法回顾性分析经手术病理证实的63例恶性和15例良性子宫内膜病变患者的1.5 T磁共振检查资料,分别测量病灶的平均表观扩散系数(m ADC)、相对表观扩散系数(r ADC)(闭孔内肌做参比部位)、最小表观扩散系数(min ADC),将良性与恶性组、子宫内膜样腺癌G1、G2、G3不同组别的ADC值相比较,进行统计学分析。结果良、恶性子宫内膜病变的m ADC、r ADC、min ADC值分别为(1.47±0.25)×10~(-3)mm~2/s、0.97±0.15、(1.18±0.26)×10~(-3)mm~2/s和(1.02±0.18)×10~(-3)mm~2/s、0.69±0.13、(0.75±0.18)×10~(-3)mm~2/s,相应ADC值比较差异均有统计学意义(P<0.05)。根据ROC曲线,曲线下面积分别为0.94、0.92、0.91。m ADC和r ADC值在子宫内膜样腺癌G1、G2、G3三个分化级别间差异均有统计学意义(P<0.05),min ADC值仅在G1和G2、G1和G3级别间差异有统计学意义(P<0.05)。结论 m ADC、r ADC、min ADC值均有助于鉴别子宫内膜良、恶性病变,用r ADC值来鉴别子宫内膜良、恶性病变更加准确,m ADC和r ADC值能辅助判断子宫内膜样腺癌的3个病理分化级别。
Objective To investigate the value of different apparent diffusion coefficient (DWI) of DWI in evaluating benign and malignant lesions of endometrium and differentiation grade of endometrial adenocarcinoma, and to find the best ADC value for distinguishing benign and malignant endometrial lesions. Methods A retrospective analysis of 1.5 T-MRI data of 63 malignant and 15 benign endometrial lesions confirmed by surgery and pathology was performed. The mean apparent diffusion coefficient (m ADC), relative apparent diffusion coefficient (r (ADC) (obturator muscle reference position), minimum apparent diffusion coefficient (min ADC), the benign and malignant group, endometrial adenocarcinoma of G1, G2, G3 different groups of ADC values were compared to carry out Statistical analysis. Results The ADC values of m ADC, r ADC and min in benign and malignant endometrial lesions were (1.47 ± 0.25) × 10 ~ (-3) mm ~ 2 / s, 0.97 ± 0.15 and 1.18 ± 0.26 × 10 ~ (-1) mm ~ 2 / s and (1.02 ± 0.18) × 10 ~ (-3) mm ~ 2 / s and 0.69 ± 0.13 and (0.75 ± 0.18) × 10 ~ (-3) mm ~ The corresponding differences in ADC values were statistically significant (P <0.05). According to the ROC curve, the area under the curve is respectively 0.94, 0.92 and 0.91. m ADC and r ADC values were significantly different between G1, G2 and G3 endometrial adenocarcinoma (P <0.05), and min ADC value only differed between G1 and G2, G1 and G3 There was statistical significance (P <0.05). Conclusion The m ADC, r ADC and min ADC values are helpful to distinguish between benign and malignant endometrial lesions. The accuracy of r ADC value to identify benign and malignant endometrial lesions is more accurate. The m ADC and r ADC values can be used to judge the intrauterine Membranous adenocarcinoma of the three pathological grade.