磁共振弥散加权成像参数对子宫内膜样腺癌与非子宫内膜样癌的鉴别诊断价值

Value of MR Diffusion Weighted Imaging Parameters in Differential Diagnosis of Endometrioid Adenocarcinoma and Non Endometrioid Carcinoma

目的:探究磁共振弥散加权成像(DWI)参数对子宫内膜样腺癌(EA)与非子宫内膜样癌的鉴别诊断价值。方法:选取2018年1月-2019年12月在笔者所在医院接受治疗的EA患者50例,命名为EA组;选取子宫癌肉瘤患者15例,命名为UEA组;另选取同时期在笔者所在医院EA检测为良性者50例,命名为Z组,均经手术病理检查确诊。对三组患者进行DWI检查,对比表观扩散参数(ADC)和相对表观扩散参数(rADC)差异,采用受试者工作特征曲线(ROC)分析ADC值对EA的鉴定效能。结果:Z组的ADC值和rADC值较EA组患者和UEA组患者大(P<0.05);ADC值对EA的鉴别曲线下面积AUC=0.661;分化程度越高,EA患者的ADC值越大(P<0.05),rADC值也越大(P<0.05)。结论:ADC值和rADC值在EA和非EA患者中存在差异,且DWI参数能对EA患者进行无创等级划分,能协助医生判断患者病情,有利于患者后期的治疗,值得在EA的临床治疗中推广。

Objective:To explore the value of MR diffusion weighted imaging (DWI) in the differential diagnosis of endometrioid adenocarcinoma (EA) and non endometrioid carcinoma.Method:A total of 50 cases of EA patients treated in our hospital from January 2018 to December 2019 were selected and named as group EA;15 cases of uterine carcinosarcoma were selected as group UEA;50 cases of benign EA detected in our hospital during the same period were named as group Z,which were confirmed by surgical pathology.DWI was performed on three groups of patients to compare the difference between apparent diffusion parameters (ADC) and relative apparent diffusion parameters (rADC).Receiver operating characteristic curve (ROC) was used to analyze the effectiveness of ADC values in the identification of EA.Result:The ADC value and rADC value of group Z were larger than those of group EA and group UEA (P<0.05);the area under the curve of ADC value versus EA was 0.661;the higher the differentiation degree,the greater the ADC value of EA patients (P<0.05),and the greater the rADC value (P<0.05).Conclusion:ADC value and rADC value are different between EA and non EA patients,and DWI parameters can be used for noninvasive classification of EA patients,and can help doctors to judge the patient’s condition,which is conducive to the later treatment of patients,and is worthy of promotion in the clinical treatment of EA.