DCE-MRI定量参数联合血清ET-1水平检测对子宫肌瘤患者治疗效果的评估价值

Evaluation value of DCE-MRI quantitative parameters combined with serum ET-1 level in the treatment of patients with uterine fibroids

目的:探讨动态增强磁共振成像(DCE-MRI)定量参数联合血清内皮素-1(ET-1)水平检测对子宫肌瘤患者治疗效果的评估价值。方法:回顾性选取2021年6月至2023年6月于郑州市第十五人民医院行子宫肌瘤剔除术患者126例为研究对象,术前1 d、术后3 d均行DCE-MRI检查,并根据术后6个月复发情况将患者分为有效组97例与无效组29例。比较两组术前1 d、术后3 d DCE-MRI定量参数[速率常数(K_(ep))、容量转移常数(K^(trans))、血管外细胞外间隙容积比(V_(e))]及血清ET-1水平,分析DCE-MRI定量参数、ET-1水平与治疗效果的相关性,并分析联合应用对治疗效果的评估价值。结果:无效组术后3 d K_(ep)、K^(trans)、V_(e)值及血清ET-1水平高于有效组(P<0.05);术后3 d DCE-MRI定量参数K_(ep)、K^(trans)、V_(e)值及血清ET-1水平与子宫肌瘤患者治疗效果均呈正相关,且联合评估治疗无效的曲线下面积(area under curve,AUC)为0.897,最佳预测敏感度、特异度分别为87.63%、82.76%。结论:DCE-MRI定量参数联合血清ET-1水平对子宫肌瘤治疗效果具有一定评估价值,可作为临床早期评估治疗效果的有效方案之一。

Objective:To evaluate the therapeutic effect of dynamic enhanced magnetic resonance imaging(DCE-MRI)combined with serum endothelin-1(ET-1)level detection in patients with uterine fibroids.Methods:A total of 126 patients who underwent myomectomy in Zhengzhou 15th People's Hospital from June 2021 to June 2023 were retrospectively selected as the study objects.DCE-MRI examinations were performed 1 day before surgery and 3 days after surgery,and the patients were divided into an effective group(97 cases)and an ineffective group(29 cases)according to the recurrence situation 6 months after surgery.Quantitative parameters of DCE-MRI[rate constant(K_(ep)),volume transfer constant(K^(trans)),extravascular extracellular space volume ratio(V_(e))]and serum ET-1 level of the 2 groups were compared 1 day before surgery and 3 days after surgery,and the correlation between DCE-MRI quantitative parameters,ET-1 level and therapeutic effect was analyzed.The evaluation value of combined application on therapeutic effect was analyzed.Results:The K_(ep),K^(trans),V_(e) values and serum ET-1 levels in the ineffective group were higher than those in the effective group(P<0.05).DCE-MRI quantitative parameters K_(ep),K^(trans),V_(e) and serum ET-1 levels at 3 days after surgery were positively correlated with the therapeutic effect of patients with uterine fibroids,and the Area under curve of combined evaluation was 0.897,and the best predictive sensitivity and specificity were 87.63%and 82.76%,respectively.Conclusion:DCE-MRI quantitative parameters combined with serum ET-1 level have a certain value in evaluating the therapeutic effect of uterine fibroids,and can be used as one of the effective schemes for early clinical evaluation of therapeutic effect.