长可变回波链分段读出弥散加权成像表观弥散系数值全瘤直方图评估Ⅰ期子宫内膜癌肌层浸润深度

Whole-tumor histogram analysis of apparent diffusion coefficient value based on readout segmentation of long variable echo-trains diffusion-weighted imaging for evaluating myometrial invasion depth of stageⅠendometrial carcinoma

目的观察长可变回波链分段读出弥散加权成像(RESOLVE-DWI)表观弥散系数(ADC)值全瘤直方图评估Ⅰ期子宫内膜癌肌层浸润深度的价值。方法回顾性分析经病理证实的53例ⅠA期及25例ⅠB期子宫内膜癌患者的MR RESOLVE-DWI资料,采用全瘤ADC值直方图分析法获得肿瘤直方图参数,包括偏度、均匀度、中位数、最大值、第90百分位数、最小值、全距、变异度、第10百分位数、峰度和平均值,比较ⅠA期与ⅠB期子宫内膜癌间各参数的差异;绘制差异有统计学意义参数的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价其鉴别ⅠA期与ⅠB期子宫内膜癌的效能。结果ⅠB期子宫内膜癌ADC值直方图参数最小值及第10百分位数低于ⅠA期(P均<0.01)、全距高于ⅠA期(P<0.01),其他参数ⅠA与ⅠB期子宫内膜癌差异均无统计学意义(P均>0.05)。ROC曲线显示,第10百分位数鉴别ⅠA期与ⅠB期子宫内膜癌的效能较高,AUC为0.81,阈值取571.80×10^(-6) mm^(2)/s时,其敏感度为79.25%,特异度为80.00%,准确率为79.76%。结论基于RESOLVE-DWI的ADC值全瘤直方图分析对评估Ⅰ期子宫内膜癌肌层浸润深度具有一定价值,其中直方图参数第10百分位数的诊断价值较高。

Objective To investigate the value of whole-tumor histogram analysis of apparent diffusion coefficient(ADC)value based on readout segmentation of long variable echo-trains diffusion-weighted imaging(RESOLVE-DWI)for evaluating myometrial invasion depth of stageⅠendometrial carcinoma.Methods MR RESOLVE-DWI data of 53 patients with stageⅠA and 25 patients in stageⅠB endometrial carcinoma confirmed by pathology were retrospectively analyzed.Tumor ADC value histogram parameters,including skewness,uniformity,median,maximum,90th percentile,minimum,range,variance,10th percentile,kurtosis and mean were measured with whole-tumor histogram analysis and compared between stageⅠA andⅠB endometrial cancers.Receiver operating characteristic(ROC)curve of parameters being statistically different between stageⅠA andⅠB endometrial cancers was drawn for evaluating the differentiating diagnostic efficacies,and the areas under curve(AUC)was calculated.Results The minimum and 10th percentile of stageⅠB endometrial cancer were significantly lower than those of stageⅠA(both P<0.01),and the range of stageⅠB endometrial cancer was significantly higher than that of stageⅠA tumor(P<0.01),while the other parameters were not significantly different between stageⅠA andⅠB(all P>0.05).ROC curve analysis showed that the 10th percentile had high diagnostic efficiency for differentiating stageⅠA andⅠB endometrial cancer,with the AUC of 0.81.Taken 571.80×10^(-6) mm^(2)/s as the cut-off value of the 10th percentile,the sensitivity was 79.25%,specificity was 80.00%,and accuracy was 79.76%.Conclusion Whole-tumor histogram analysis of ADC value based on RESOLVE-DWI had certain value for evaluating the depth of myometrial invasion of stageⅠendometrial carcinoma.The 10th percentile of histogram parameter had high diagnostic value.