摘要
目的探讨表观扩散系数(ADC)直方图分析法鉴别子宫平滑肌瘤(ULM)与平滑肌肉瘤(ULMS)的诊断价值。方法回顾性分析本院经手术病理证实20例ULMS患者(共24个病灶)和52例ULM患者(共68个病灶)的MRI影像资料。所有患者均行1.5 T盆腔MRI常规和扩散加权成像(DWI)扫描。采用FireVoxel软件对病灶的ADC图进行直方图分析,并获得直方图参数:各百分比ADC值、平均ADC(ADCmean)、最小ADC(ADCmin)、最大ADC(ADCmax)、偏度及峰度。采用t检验(正态分布)或Mann-Whitney U检验(偏态分布)比较两组间直方图参数。采用受试者工作特征(ROC)曲线评估各参数的诊断效能。结果ULMS的ADC值直方图以正偏态分布为主,ULM以负偏态为主,二者的偏度值差异有统计学意义(P<0.05);ULMS的ADCmean、ADCmin、ADC_5th、ADC_25th、ADC_50th、ADC_75th和ADC_95th均低于ULM,差异均有统计学意义(P均<0.05);ADCmin鉴别ULMS和ULM的效能最高,曲线下面积(AUC)为0.858,敏感度及特异度分别为90.1%和80.5%;偏度值显示最高的特异度84.3%。结论DWI的ADC直方图分析法对鉴别ULMS和ULM具有一定价值,其中ADCmin及偏度值提供帮助最大。
Objective To explore the utility of apparent diffusion coefficient histogram analysis in differentiation be-tween uterine leiomyoma and leiomyosarcoma.Methods Twenty patients with leiomyosarcoma(24 lesions)and 52 pa-tients with leiomyoma(68 lesions),who underwent preoperative routine pelvic MRI sequences and DWI,were retrospec-tively evaluated.The whole-lesion ADC values derived from histogram analysis(including ADCmean,ADCmin,ADCmax,ADC_5th,ADC_25th,ADC_75th,ADC_95th,skew and kurtosis)were measured for each patient.All parameters between u-terine leiomyoma and leiomyosarcoma were compared by using the Student's t test or Mann-Whitney U test.ROC analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the two groups.Results The negative skewness of ADC histograms were mostly seen in the leiomyosarcoma group,while the postive skewness were present in the majority of leiomyoma,the difference of the skewness between the two groups was statistically significant(P<0.05).ADCmean,ADCmin,5th percentile ADC,25th percentile ADC,50th percentile ADC,75th percentile ADC and 95th percen-tile ADC(all P<0.05)were significantly lower in leiomyosarcoma.ADCmin achieved the highest AUC(0.858)in differenti-ating uterine leiomyosarcoma and leiomyoma.The sensitivity and specificity were 90.1%and 80.5%.The skewness showed the highest specificity(84.3%).Conclusion ADC histogram analysis is helpful for differentiating uterine leio-myosarcoma from leiomyoma;ADCmin and skewness show better efficacy.
作者
廖俊杰
王乐富
刘永志
何国华
LIAO Junjie;WNAG Lefu;LIU Yongzhi(Department of Radiology,Huizhou Central People's Hospital,Huizhou,Guangdong)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第12期2371-2375,共5页
Journal of Clinical Radiology
基金
惠州市科技计划医疗卫生项目(编号:2019Y027)
关键词
平滑肌肉瘤
子宫肌瘤
表观扩散系数
直方图
Leiomyosarcoma
Leiomyoma
Apparent diffusion coefficient
Histogram
