武雅琳, 刘颖, 马菊香, 韩丽珠, 叶兆祥. MRI定量参数预测子宫内膜癌病理分级的价值[J]. 中国肿瘤临床, 2019, 46(19): 982-985. DOI: 10.3969/j.issn.1000-8179.2019.19.030
引用本文: 武雅琳, 刘颖, 马菊香, 韩丽珠, 叶兆祥. MRI定量参数预测子宫内膜癌病理分级的价值[J]. 中国肿瘤临床, 2019, 46(19): 982-985. DOI: 10.3969/j.issn.1000-8179.2019.19.030
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Wu Yalin, Liu Ying, Ma Juxiang, Han Lizhu, Ye Zhaoxiang. Value of quantitative MRI parameters in predicting the pathological grade of endometrial carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(19): 982-985. DOI: 10.3969/j.issn.1000-8179.2019.19.030
Citation: Wu Yalin, Liu Ying, Ma Juxiang, Han Lizhu, Ye Zhaoxiang. Value of quantitative MRI parameters in predicting the pathological grade of endometrial carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(19): 982-985. DOI: 10.3969/j.issn.1000-8179.2019.19.030
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MRI定量参数预测子宫内膜癌病理分级的价值

Value of quantitative MRI parameters in predicting the pathological grade of endometrial carcinoma

    摘要
  • 摘要:
      目的  探究MRI定量参数预测子宫内膜癌病理分级的价值。
      方法  回顾性分析2014年2月至2019年1月188例经天津医科大学肿瘤医院手术病理证实为子宫内膜癌（endometrial carcinoma，EC）患者的MRI图像资料。计算肿瘤及子宫的体积及肿瘤/子宫体积比（neoplasm/uterus volume ratio，N/U），分别测量病灶及正常子宫肌层、闭孔内肌、臀大肌三处参比部位的表观扩散系数（apparent diffusion coefficient，ADC）（b值为800 s/mm2），计算ADC平均值（ADCmean）、ADC值的离散系数（coefficient variance，CVADC）及相应的ADC比值（rADC）。利用非参数检验评估EC病理分级间各参数的差异；利用受试者工作曲线（receiver operating charac-teristic，ROC）及Logistic回归分析法评估各参数对高级别EC的预测效能。
      结果  高级别EC的N/U明显高于低级别（P＜0.001），其ADCmean及3处rADC均低于低级别EC（均P＜0.001）；Logistic回归分析显示N/U及rADC子宫肌层可独立预测高级别EC（P=0.018及P＜0.001），当N/U＞0.11、rADC子宫肌层＜0.65时联合模型ROC曲线下面积（AUC）为0.777、灵敏度为70.97%、特异度为76.56%。
      结论  MRI定量参数对于术前预测EC病理分级具有一定的价值。

     

    Abstract:
      Objective  To assess the value of quantitative magnetic resonance imaging (MRI) parameters in the prediction of the pathological grade of endometrial carcinoma (EC).
      Methods  In this study, the MR images of 188 patients with a confirmed diagnosis of EC, on the basis of surgical pathology results, treated at Tianjin Medical University Cancer Institute and Hospital between February 2014 and January 2019 were analyzed retrospectively. The volumes of the neoplasm and uterus and the corresponding neoplasm/uterus volume ratio (N/U) were calculated. The apparent diffusion coefficient (ADC) of the lesion and three reference positions (normal uterine myometrium, musculus obturator internus, and gluteus maximus) was measured, and the mean ADC (ADCmean), the coefficient of variance of ADC, and the corresponding ADC ratio (rADC) were calculated. Differences in the pathological grades under various parameters were evaluated with a nonparametric test. The efficacy of various parameters in predicting high-grade EC was evaluated by receiver operating characteristic (ROC) and Logistic regression analyses.
      Results  N/U of high-grade EC was significantly higher than that of low-grade EC (P < 0.001). The mean ADC and three groups of rADC values for high-grade EC were significantly lower than those for lowgrade EC (all P < 0.001). Logistic regression analysis showed that N/U and rADC uterine myometrium independently predicted highgrade EC (P=0.018; P < 0.001). When N/U was more than 0.11 and rADC uterine myometrium was less than 0.65, the area under the curve of the combination of the two parameters was 0.777, with a sensitivity of 70.97% and a specificity of 70.97%.
      Conclusions  The quantitative MRI parameters N/U and rADC have potential value in predicting the pathological grade of EC before surgery.

     

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