DWI在宫腔积脓和宫腔积液鉴别诊断中的价值

Value of DWI in differential diagnosis of uterine empyema and uterine cavity fluid

目的探讨DWI序列对宫腔积脓和宫腔积液的鉴别诊断价值。材料与方法回顾分析44例经手术病理或临床证实的宫腔积脓和宫腔积液患者的宫腔DWI信号特征,测量其表观扩散系数(apparent diffusion coefficient,ADC),比较其差异,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线。结果 20例宫腔积脓在DWI上18例呈高信号,1例呈不均匀高信号,1例呈低信号,平均ADC值为(0.78±0.21)×10^(-3) mm^2/s;24例宫腔积液在DWI上22例呈低信号,2例呈高信号,平均ADC值为(1.81±0.38)×10^(-3) mm^2/s。两者ADC值差异有统计学意义(P<0.001),且ADC值鉴别子宫腔积脓和积液的最佳截断点为1.20×10^(-3) mm^2/s,敏感性为91.7%,特异性为95.0%。结论 ADC值可以用于宫腔积脓和宫腔积液的鉴别,其诊断临界值为1.20×10^(-3) mm^2/s。

Abstract Objective： To investigate the value of DWI sequence in the differential diagnosis of uterine empyema and uterine cavity fluid. Materials and Methods： Forty-four cases of DWI signal of uterine empyema and uterine cavity fluid were retrospectively analyzed, these cases were confirmed by pathology or clinic. Afterwards the apparent diffusion coefficient （ADC） was measured and the receiver operating characteristic （ROC） curve of the ADC value was drawn. Results： In DW1, 20 cases of uterine empyema, 18 cases showed high signal, 1 case showed inhomogeneous high signal, I case showed low signal, mean ADC value was （0.78±0.21）×10^-3 mm^2/s. In DWI, 24 cases of uterine cavity fluid, 22 cases showed low signal, 2 cases showed high signal, mean ADC value was （1.81±0.38）×10^-3 mm^2/s. There was significant difference in ADC value between the two groups （P〈0.001）, the optimum cutoff point for ADC values was 1.20±10×10^-3 mm^2/s, the sensitivity was 91.7% and the specificity was 95.0%. Conclusions： The ADC value can be used to identify the uterine empyema and uterine cavity fluid, and the cutoffvalue was 1.20×10^-3 mm^2/s.