多模态磁共振成像检查在子宫肌瘤诊断中的优势对照分析

Comparative Analysis of Advantages of Multimodal Magnetic Resonance Imaging Examination in the Diagnosis of Uterine Fibroids

目的:探讨多模态磁共振成像(MRI)检查在子宫肌瘤诊断中的优势。方法:回顾性分析2019年5月—2021年6月仁怀市人民医院收治的53例子宫肌瘤患者的资料,给予常规MRI检查、多模态MRI检查、手术病理检查。统计手术病理检查结果(诊断金标准),对比常规MRI检查与手术病理检查、多模态MRI检查与手术病理检查,统计分析多模态MRI检查与常规MRI检查的误诊率和漏诊率、诊断效能、不同类型子宫肌瘤诊断准确率、不同直径子宫肌瘤检出率。结果:53例子宫肌瘤患者中,手术病理检查阳性47例,阴性6例;常规MRI检查阳性43例,阴性10例;MRI多模态检查阳性46例,阴性7例。经术后病理诊断证实的47例子宫肌瘤患者,常规MRI检查的误诊率、漏诊率显著高于多模态MRI检查,差异有统计学意义(P<0.05);多模态MRI检查诊断敏感度、特异度、准确度和阴性预测值显著高于常规MRI检查,差异有统计学意义(P<0.05);多模态MRI检查诊断阳性预测值高于常规MRI检查,但差异无统计学意义(P>0.05);多模态MRI检查肌壁间肌瘤诊断准确率及总诊断准确率显著高于常规MRI检查,差异有统计学意义(P<0.05);多模态MRI检查黏膜下肌瘤、浆膜下肌瘤、多发性子宫肌瘤、宫颈肌瘤、阔韧带肌瘤诊断准确率高于常规MRI检查,但差异无统计学意义(P>0.05)。多模态MRI检查对直径<1 cm、1~3 cm、>3 cm肌瘤的检出率均显著高于常规MRI检查,差异有统计学意义(P<0.05)。结论:多模态MRI检查在子宫肌瘤诊断中具有更高的诊断价值,可明显提高诊断准确率,可作为常规有效检查手段。

Objective:To explore the advantages of multimodal magnetic resonance imaging(MRI)examination in the diagnosis of uterine fibroids.Method:The data of 53 patients with uterine fibroids who admitted to Renhuai People's Hospital from May 2019 to June 2021 were retrospectively analyzed,routine MRI examination,multimodal MRI examination and surgical pathological examination were performed.The results of surgical pathological examination(diagnostic gold standard)were statistically analyzed,conventional MRI examination and surgical pathological examination,multimodal MRI examination and surgical pathological examination were compared,the misdiagnosis rate and missed diagnosis rate,diagnostic efficiency,diagnostic accuracy of different types of uterine fibroids and detection rate of uterine fibroids with different diameters were statistically analyzed.Result:Among 53 patients with uterine fibroids,surgical pathological examination showed 47 cases were positive and 6 cases were negative;routine MRI examination showed 43 cases were positive and 10 cases were negative;multimodal MRI examination showed 46 cases were positive and 7 cases were negative.A total of 47 patients with uterine fibroids confirmed by pathological diagnosis after surgery,the misdiagnosis rate and missed diagnosis rate of conventional MRI examination were significantly higher than those of multimodal MRI examination,and the differences were statistically significant(P<0.05);the diagnostic sensitivity,specificity,accuracy and negative predictive value of multimodal MRI examination were significantly higher than those of conventional MRI examination,and the differences were statistically significant(P<0.05);the positive predictive value of multimodal MRI examination was higher than that of conventional MRI examination,but the difference was not statistically significant(P>0.05);the diagnostic accuracy and total diagnostic accuracy rate of multimodal MRI examination for intramural fibroids were significantly higher than those of conventional MRI examination,and the differences were statistically significant(P<0.05);the diagnostic accuracy of multimodal MRI examination for submucosal fibroids,subserous fibroids,multiple uterine fibroids,cervical fibroids and broad ligament fibroids were higher than those of conventional MRI examination,but the differences were not statistically significant(P>0.05).The detection rate of fibroids with diameters<1 cm,1-3 cm,and>3 cm using multimodal MRI examination were significantly higher than those using conventional MRI examination,and the differences were statistically significant(P<0.05).Conclusion:Multimodal MRI examination has higher diagnostic value in the diagnosis of uterine fibroids,and it can significantly improve the accuracy of uterine fibroid diagnosis,it can be used as a routine and effective examination method for uterine fibroid diagnosis.