动态增强MRI对子宫肌瘤病理亚型的鉴别价值及其与患者免疫组化指标的相关性

The value of dynamic enhanced MRI in the differential diagnosis of uterine fibroids and its correlation with immunohistochemistry

目的探讨动态增强MRI对子宫肌瘤病理亚型的鉴别价值及其与患者免疫组化指标的相关性。方法选取2018年6月至2019年6月于本院就诊的68例行子宫肌瘤剔除术患者为研究对象。手术前对患者进行动态增强MRI(DCE-MRI)扫描。比较三组定量灌注参数(Ktrans、Kep、Ve、Vp),分析DCE-MRI定量灌注参数和免疫组化结果[微血管密度(MVD)、血管内皮生长因子(Ve GF)、Ki-67]的相关性。结果68例病灶中,普通型肌瘤32例,细胞型肌瘤15例,变性型肌瘤21例。Ktrans、Kep值及体积指标三组间有统计学差异,细胞组Ktrans、Kep值显著高于普通组及变性组,且细胞组和变性组体积均大于普通组(P<0.05);Pearson结果显示,各定量灌注参数与MVD、VeGF、Ki-67呈正相关(P<0.05)。结论DCE-MRI定量灌注参数可鉴别子宫肌瘤病理亚型,且定量灌注参数与MVD表达存在相关性,可作为评价子宫肌瘤血管生成及细胞增殖及活跃的因子。

Objective To explore the value of dynamic enhanced MRI in the differential diagnosis of uterine fibroids and its correlation with immunohistochemistry.Methods A total of 68 patients undergoing hysteromyomectomy in our hospital from June 2018 to June 2019 were selected as the research subjects.Dynamic contrast-enhanced MRI(DCE-MRI)scans were performed before surgery.The quantitative perfusion parameters(Ktrans,KEP,VE,VP)of the three groups were compared to analyze the correlation between the quantitative perfusion parameters of DCE-MRI and the results of immunohistochemistry[Microvessel density(MVD),vascular endothelial growth factor(VE GF),Ki-67].Results Among the 68 lesions,32 cases were common fibroids,15 cases were cell fibroids and 21 cases were degenerative fibroids.There were significant differences in the values of Ktrans,Kep and volume indexes among the three groups.The values of Ktrans and Kep in cell group were significantly higher than those in normal group and denatured group,and the volumes of cell group and denatured group were higher than those in normal group(P<0.05).Pearson results showed that the quantitative perfusion parameters were positively correlated with MVD,VEGF and Ki-67(P<0.05).Conclusion DCE-MRI quantitative perfusion parameters can identify pathological subtypes of uterine fibroids,and quantitative perfusion parameters are correlated with MVD expression,which can be used as a factor to evaluate uterine fibroid angiogenesis and cell proliferation and activity.