动态对比增强磁共振结合表观弥散系数鉴别恶性子宫间叶性肿瘤与弥散受限的子宫肌瘤
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

R445.2

基金项目:

国家自然科学基金(82071919)


Dynamic ⁃ contrast enhanced MRI combined diffusion ⁃ weighted image in differentiating malignant uterine mesenchymal tumours from leiomyomas with restricted diffusion on diffusion weighted imaging
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:评估动态对比增强磁共振成像(dynamic-contrast enhanced magnetic resonance imaging,DCE-MRI)和表观弥散系数(apparent diffusion coefficient,ADC)在鉴别恶性潜能未定的平滑肌肿瘤(smooth muscle tumours of uncertain malignant poten- tial,STUMP)/恶性子宫间叶性肿瘤与在弥散加权成像(diffusion-weighted imaging,DWI)上表现为弥散受限的平滑肌瘤中的诊断效能。方法:连续收集2016年1月—2021年9月病理证实为子宫间叶性肿瘤患者68例,包括23例STUMP/恶性子宫间叶性肿瘤与45例弥散受限的平滑肌瘤,这些病灶在DWI(b=800 s/mm2 )上均显示为弥散受限。对病灶进行常规MR特征评估以及 ADC和DCE-MRI参数的直方图分析,受试者工作特征(receiver operating characteristic,ROC)曲线用于评估诊断性能。结果:STUMP/恶性子宫间叶性肿瘤囊变坏死的发生率高于非恶性组(34.8% vs. 8.9%,P=0.016)。STUMP/恶性组的ADC 中位数和Ve中位数显著低于非恶性组(P < 0.001,P=0.012),鉴别STUMP/恶性子宫间叶性肿瘤的ROC曲线下面积(area under the curve,AUC)分别为0.795和0.713,ADC 中位数+Ve 中位数联合可将AUC提高到0.850,ADC 中位数+Ve 中位数+有无囊变坏死联合得到更高AUC(0.883)。结论:ADC、DCE-MRI参数与常规MR特征联合可作为鉴别STUMP/恶性子宫间叶性肿瘤与弥散受限的平滑肌瘤的敏感指标。

    Abstract:

    Objective:To evaluate the diagnostic ability of dynamic-contrast enhanced magnetic resonance imaging(DCE-MRI)and apparent diffusion coefficient(ADC)in differentiating smooth muscle tumours of uncertain malignant potential(STUMP)or malignant uterine mesenchymal tumours from leiomyomas that manifests restricted diffusion on diffusion-weighted imaging(DWI). Methods:A total of 68 patients with pathologically confirmed uterine mesenchymal tumors that manifest restricted diffusion on DWI(b=800 s/mm2 ) were included between January 2016 and September 2021. We assessed conventional MR features of the lesions. Histogram analysis was performed based on ADC and DCE -MRI,and the derived quantitative parameters were compared between STUMP or malignant uterine mesenchymal tumours(n=23)and leiomyomas that manifest restricted diffusion on DWI(n=45). Receiver operating characteristic(ROC)curve was used for evaluating diagnostic performance. Results:The incidence of cystic necrosis in the STUMP or malignant group was higher than that in the non -malignant group(34.8% vs. 8.9%,P=0.016). ADCmedian and Ve median of the STUMP or malignant group were significantly lower than nonmalignant group(P < 0.001,P=0.012),with the highest area under the curve(AUC) for distinguishing STUMP or malignant uterine mesenchymal tumours reaching 0.795 and 0.713. ADCmedian+ Ve median improved AUC to 0.850. ADCmedian+Ve median+with or without cystic necrosis yield the highest AUC(0.883). Conclusion:The combination of ADC,DCE-MRI parameters and conventional MR features may serve as sensitive indicators for differentiating malignant uterine mesenchymal tumours from leiomyomas showing restricted diffusion on DWI.

    参考文献
    相似文献
    引证文献
引用本文

蒋晓婷,宋佳成,张爱宁,罗成燕,陈婷,刘希胜.动态对比增强磁共振结合表观弥散系数鉴别恶性子宫间叶性肿瘤与弥散受限的子宫肌瘤[J].南京医科大学学报(自然科学版),2023,(5):626-633

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2023-01-27
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2023-05-18
  • 出版日期:
通知关闭
郑重声明