DCE-MRI定量参数对子宫内膜癌诊断、肌层浸润程度的评估价值分析

Value of DCE-MRI Quantitative Parameters in the Diagnosis of Endometrial Cancer and Evaluation of Myometrial Invasion

目的探讨磁共振动态增强成像(DCE-MRI)定量参数对子宫内膜癌诊断、肌层浸润程度的评估价值。方法将62例子宫内膜癌患者作为子宫内膜癌组,并以同期治疗的良性病变患者60例为良性病变组。比较两组DCE-MRI定量参数[容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)],分析各参数对子宫内膜癌的诊断价值;根据肌层浸润程度将子宫内膜癌患者分为深肌层浸润组、浅肌层浸润组及未浸润组,比较三组DCE-MRI定量参数,观察DCE-MRI定量参数与肌层浸润程度的相关性,并分析各参数对子宫内膜癌肌层浸润的诊断价值及对深、浅肌层浸润的鉴别价值。结果子宫内膜癌组的Ktrans、Kep、Ve值均大于良性病变组(P<0.05),Ktrans、Kep、Ve值诊断子宫内膜癌的AUC均大于0.7;深肌层浸润组及浅肌层浸润组的Ktrans、Kep、Ve值均大于未浸润组,肌层浸润程度与Ktrans、Kep呈正相关(P<0.05);Ktrans、Kep、Ve值诊断子宫内膜癌肌层浸润的AUC均大于0.7,Ktrans、Kep、Ve值鉴别子宫内膜癌深、浅肌层浸润的AUC均小于0.7。结论DCE-MRI定量参数对子宫内膜癌及肌层浸润具有诊断价值,且与肌层浸润程度相关,但对深、浅肌层浸润的鉴别价值较低。

Objective To explore the value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters in the diagnosis of endometrial cancer and evaluation of myometrial invasion.Methods 62 patients with endometrial cancer were enrolled as endometrial cancer group,while another 60 patients with benign lesions who were treated during the same period were enrolled as benign lesion group.DCE-MRI quantitative parameters[volume transfer constant(Ktrans),rate constant(Kep),extravascular extracellular volume fraction(Ve)]were compared between the two groups.The diagnostic value of each parameter for endometrial cancer was analyzed.According to myometrial invasion degree,endometrial cancer patients were divided into deep myometrial invasion group,superficial myometrial invasion group and non-invasion group.DCE-MRI quantitative parameters were compared among the 3 groups.The correlation between DCE-MRI quantitative parameters and myometrial invasion degree was observed.The value of different parameters for diagnosis of myometrial invasion and distinguishing deep myometrial invasion from superficial myometrial invasion was analyzed.Results Ktrans,Kep and Ve in endometrial cancer group were greater than those in benign lesion group(P<0.05).AUC values of the Ktrans,Kep and Ve for diagnosis of endometrial cancer were all greater than 0.7.Ktrans,Kep and Ve in deep myometrial invasion group and superficial myometrial invasion group were greater than those in non-invasion group.The myometrial invasion degree was positively correlated with Ktrans and Kep(P<0.05).AUC values of Ktrans,Kep and Ve for the diagnosis of endometrial cancer myometrial invasion were all greater than 0.7,and whose AUC values for distinguishing deep myometrial invasion from superficial myometrial invasion were all lower than 0.7.Conclusion DCE-MRI quantitative parameters are of diagnostic value for endometrial cancer and myometrial invasion,which are related to myometrial invasion degree.However,their value in distinguishing deep myometrial invasion from superficial myometrial invasion is low.