刘柳恒,吕富荣,肖智博,吕发金,李佳,李芊.DWI诊断细胞型子宫肌瘤[J].中国医学影像技术,2016,32(10):1550~1554
DWI诊断细胞型子宫肌瘤
DWI in diagnosis of cellular uterine leiomyoma
投稿时间:2016-02-24  修订日期:2016-08-02
DOI:10.13929/j.1003-3289.2016.10.020
中文关键词:  子宫肌瘤  扩散磁共振成像  表观扩散系数
英文关键词:Leiomyoma  Diffusion magnetic resonance imaging  Apparent diffusion coefficient
基金项目:国家临床重点专科建设项目(2013544)、重庆市渝中区科技计划项目(20120211)
作者单位E-mail
刘柳恒 重庆医科大学附属第一医院放射科, 重庆 400016  
吕富荣 重庆医科大学附属第一医院放射科, 重庆 400016 lfr918@sina.com 
肖智博 重庆医科大学附属第一医院放射科, 重庆 400016  
吕发金 重庆医科大学附属第一医院放射科, 重庆 400016  
李佳 重庆医科大学附属第一医院放射科, 重庆 400016  
李芊 重庆医科大学附属第一医院放射科, 重庆 400016  
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中文摘要:
      目的 探讨DWI诊断细胞型子宫肌瘤的价值。方法 收集经术后病理证实为子宫肌瘤的患者181例(共纳入181个子宫肌瘤)。所有患者术前均接受常规MR平扫、增强扫描及DWI检查。测量子宫肌瘤ADC值,并将DWI信号特征分为低、等、高信号。将DWI呈低信号者诊断为普通型,DWI呈等、高信号者根据ADC值判断为细胞型或普通型子宫肌瘤。以病理结果为金标准,绘制DWI呈等、高信号的子宫肌瘤中,ADC值诊断细胞型子宫肌瘤的ROC曲线,并计算诊断效能。结果 病理诊断细胞型子宫肌瘤44个,其中DWI呈等信号20个,高信号24个;普通型子宫肌瘤137个,其中DWI呈低信号78个,等信号50个,高信号9个。DWI呈低信号的子宫肌瘤诊断结果与病理结果一致。细胞型和普通型子宫肌瘤,DWI呈等、高信号的细胞型和普通型子宫肌瘤ADC值差异均有统计学意义(P均<0.01)。DWI呈等、高信号子宫肌瘤中,以ADC=1.27×10-3 mm2/s为阈值,诊断细胞型子宫肌瘤的ROC曲线下面积为0.84[95%CI(1.76,0.91),P<0.01],敏感度及特异度分别为90.91%(40/44)、69.49%(41/59)。DWI信号联合ADC值诊断细胞型子宫肌瘤与病理结果有较高的一致性(Kappa=0.702,P<0.01),敏感度、特异度、准确率、阳性预测值及阴性预测值分别为90.91%(40/44)、86.86%(119/137)、87.85%(159/181)、68.97%(40/58)、96.75%(119/123)。结论 DWI诊断细胞型子宫肌瘤有较高的临床应用价值。
英文摘要:
      Objective To investigate the value of DWI in diagnosis of cellular uterine leiomyoma.Methods Totally 181 cases of uterine leiomyomas confirmed by pathology after surgery were collected, and 181 uterine leiomyomas were included in the study. All the patients underwent routine MR plain scan, enhanced scan and DWI examination. ADC value of the uterine leiomyomas was measured, and DWI manifestations were devided into low, equal and high signal intensity. Uterine leiomyomas with low DWI signal intensity were diagnosed as ordinary uterine leiomyomas. ADC value was used to diagnose uterine leiomyoma types with equal and high DWI signal intensity. Taking pathological results as gold standard, ROC curve was drawn to evaluate the value of ADC in diagnostic results of cellular uterine leiomyoma, and the diagnostic efficacy was calculated.Results There were 44 cellular uterine leiomyomas confirmed by pathological diagnosis, including 20 equal signal and 24 high signal of DWI. There were 137 ordinary uterine leiomyomas, including 78 low signal, 50 equal signal and 9 high signal of DWI. The diagnostic results of uterine leiomyoma with low signal in DWI was consistent with the pathological results. Significant differences of ADC value were found between the cellular and ordinary uterine leiomyomas in all the uterine leiomyomas, so was in the equal and high DWI signal uterine leiomyomas (both P<0.01). Taking ADC=1.27×10-3 mm2/s as threshold to diagnose cellular uterine leiomyoma in the equal and high DWI signal uterine leiomyomas, the area under ROC curve was 0.84 (95%CI[0.76,0.91], P<0.01), and sensitivity and specificity were 90.91% (40/44) and 69.49% (41/59), respectively. DWI signal combined with ADC value in diagnosis of cellular uterine leiomyoma had good consistency with pathological results (Kappa=0.702, P<0.01), and sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 90.91% (40/44), 86.86% (119/137), 87.85% (159/181), 68.97% (40/58), 96.75% (119/123), respectively.Conclusion DWI in diagnosis of cellular uterine leiomyoma has high clinical application value.
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