磁共振DWI联合ADC对子宫肉瘤和变性子宫肌瘤的诊断价值

Differential diagnostic value of DWI combined with ADC in uterine sarcoma and degenerative uterine fibroids

目的探讨磁共振弥散加权成像(DWI)联合表观弥散系数(ADC)对子宫肉瘤和变性子宫肌瘤的诊断价值。方法回顾性分析2017年12月至2018年12月该院收治的27例子宫肉瘤患者,62例变性子宫肌瘤患者的临床资料,所有患者均行磁共振DWI检查并获取ADC,比较子宫肉瘤与变性子宫肌瘤磁共振DWI影像特点及肿瘤内部、正常肌层的ADC,比较磁共振DWI、ADC及磁共振DWI联合ADC鉴别诊断子宫肉瘤和变性子宫肌瘤的诊断效能。结果子宫肉瘤与变性子宫肌瘤磁共振DWI影像中边缘规整度、信号强度、内膜受累情况比较均差异有统计学意义(P<0.05);子宫肉瘤患者正常肌层ADC与变性子宫肌瘤患者比较差异无统计学意义(P>0.05);子宫肉瘤患者肿瘤内部ADC较变性子宫肌瘤患者显著降低(P<0.05);子宫肉瘤与变性子宫肌瘤内部ADC较正常肌层均显著降低(P<0.05);ADC鉴别诊断子宫肉瘤和变性子宫肌瘤的诊断效能显著优于磁共振DWI(P<0.05);磁共振DWI联合ADC鉴别诊断子宫肉瘤和变性子宫肌瘤的诊断效能明显优于单独诊断,差异有统计学意义(P<0.05)。结论磁共振DWI联合ADC是鉴别诊断子宫肉瘤和变性子宫肌瘤的有效方法,能提高诊断准确性,可在临床广泛推广应用。

Objective To explore the diagnosis value of diffusion weighted imaging (DWI) combined with apparent diffusion coefficient (ADC) for uterine sarcoma and degenerative uterine fibroids. Methods Retrospective analysis of clinical data of 27 patients with uterine sarcoma and 62 patients with degenerative uterine fibroids admitted from December 2017 to December 2018.All patients underwent DWI and acquired ADC to compare uterine sarcoma and degeneration uterine fibroids.The characteristics of DWI imaging of degeneration uterine fibroids,and ADC in internal and normal muscle layers were compared.The diagnostic efficacy of DWI,ADC and DWI combined with ADC in the differential diagnosis of uterine sarcoma and degenerative uterine fibroids. Results The margin regularity,signal intensity and endometrial involvement showed by DWI images had statistic difference between uterine sarcoma and degenerative uterine fibroids ( P <0.05).ADC value of normal myometrium of patients with uterine sarcoma had no difference with those of the patients with degenerative uterine fibroids ( P >0.05).The ADC value in uterine sarcoma patients was significantly lower than that in degenerative uterine fibroids patients ( P <0.05).The ADC value in uterine sarcoma and degenerative uterine fibroids were significantly lower than those in normal myometrium ( P <0.05).The diagnostic efficacy of ADC for differential diagnosis of uterine sarcoma and degenerative uterine fibroids was significantly better than that of DWI ( P <0.05).The diagnostic efficacy of DWI combined with ADC value in differential diagnosis of uterine sarcoma and degenerative uterine fibroids was significantly better than diagnosis alone ( P <0.05). Conclusion Diagnostic value of DWI combined with ADC in uterine sarcoma and degenerative uterine fibroids is relatively high,which is worthy of promotion.