MRI与US对子宫腺肌病的诊断价值的对照研究

Comarative Study of MRI and US in the Diagnosis of Adenomyosis

目的探讨MRI和US两种检查对子宫腺肌病的临床应用价值。方法 102例疑诊的子宫腺肌病或者子宫平滑肌瘤的患者均行MRI和US检查。所有病例行常规M R I序列及D W I序列(b=700s/mm?)扫描,测出病变的ADC值;4 0例强化扫描。U S行T A S或TVS+CDFI检查。病理结果作为金标准对照研究。结果 1、MRI诊断子宫腺肌病Se、Sp、Ac及PPV、NPV、LR+、LR-分别为91.67%、96.30%、94.12%、95.65%、92.86%、24.78、0.09,US诊断子宫腺肌病的Se、Sp、Ac及PPV、NPV、LR+、LR-分别为78.72%、87.27%、83.33%、84.09%、82.76%、6.18、0.24。两种方法的Se、Sp、Ac之间通过χ?检验得出P值=0.000、0.022、0.015,有统计学意义(P<0.05)。2、b值=700s/mm2时,子宫腺肌病ADC值1.59±0.20×10-3mm2/s,子宫肌瘤ADC值为1.70±0.33×10-3mm2/s,两者之间有统计学差异(P<0.05)。结论 1、对子宫腺肌病的诊断MRI优越于US检查。2、子宫腺肌病与子宫平滑肌瘤ADC值之间具有统计学差异,表明两种病变内组织病理生理状态和空间结构变化不同。

Objective The aim of this study was to compare the diagnostic performance of Magnetic Resonance Imaging （MRI） with Ultrasound （US） examination in the diagnosis of uterine adenomyosis. Materials and Methods 102 women who were suspected uterine adenomyosis or leiomyoma in initial clinical diagnosis were enrolled. All patients respec- tively were subjected to MRI and US. Moreover, they underwent diffusion-weighted imaging （DWI） in addition to routine MR imaging,and measured ADC value of lesion tissues and compared statistical differences. 40 patients were underwent dynamic en- hanced scans. Histopathologic examination was conducted as the golden standard. Results 1. The sensitivity, specificity, accuracy lbr diagnosis of MRI adenomyosis were 91.67%, 96.30%, 94.12%, 95.65%, 92.86%, 24.78, 0.09. The sensitivity, specificity, accuracy and PPV, NPV, LR＋ and LR- for diagnosis of US adenomyosis were 78.72%, 87.27%, 83.33%, 84.09%, 82.76%, 6.18, 0.24. The comparison of sensitivity, specificity and accuracy of two diagnosis had significant differences on statistics （P=0.000, 0.022, 0.015〈0.05）. 2. b=700s/mm2, the ADC value of adenomyosis 1.59± 0.20× 10-3mm2/s, myoma of uterus ADC value 1.70 ± 0.33 × 10-3mm-3/s. There are notable discrepancy on statistics （P = 0. 004 〈0.05）. Conclusionl The sensitivity, specificity, accuracy for MRI are more superior than for US in the diagnosis of adenomyosis, and MRI examination has outstanding clinical practical value. 2.There are significant discrepancy on statistics between ADC values of adenomyosis and uterine myoma, suggest that their pathological changes and spatial struc- ture should be different.