单指数、双指数及拉伸指数模型扩散加权成像参数诊断子宫内膜癌

摘要

Purpose To explore the application of single index,double exponential and tensile density index model diffusion weighted imaging and other parameters on endometrial carcinoma diagnosis to offer new ideas for it.Materials and Methods Intravoxel incoherent motion imaging data of 28 endometrial carcinoma patients and 24 patients of normal endometrium were analyzed retrospectively.Single index,double exponential and DWI parameter of endometrial carcinoma tissue and normal endometrial tissue were measured respectively,including standard apparent diffusion coefficient (ADC-stand),slow apparent diffusion coefficient (ADC-slow),fast apparent diffusion coefficient (ADC-fast,perfusion fraction (f),distributed diffusion coefficient (DDC) and a.Receiver operator characteristic (ROC) curve was adopted to assess threshold value and diagnostic efficiency of each parameter,and analyzed difference among each parameter in two groups and relativity of each parameter in the same group.Results ADC-stand,ADC-slow,f,DDC and a in endometrial carcinoma group were all lower than those in normal endometrium group.The difference was statistically significant (P＜0.05).The difference of ADC-fast was not statistically significant (P＞0.05).Areas of ADC-stand and ADC-slow on ROC curve were 0.949 and 0.911 respectively,and threshold values were 1.245×10-3 mm2/s and 0.998× 10-3 mm2/s.ADC-stand in endometrial carcinoma group was positive correlated with ADC-slow and DDC value (r=0.787 and 0.880,P＜0.05).ADC-slow was significantly lower than ADC-stand (P＜0.05).Conclusion The differences in single index,double exponential and DWI can provide new ideas for endometrial carcinoma diagnosis.%目的 探讨单指数、双指数及拉伸指数模型扩散加权成像(DWI)各参数在诊断子宫内膜癌中的价值,为子宫内膜癌的诊断提供新的思路.资料与方法 回顾性分析28例子宫内膜癌患者和24例子宫内膜正常患者的体素内不相干运动成像资料,分别测量子宫内膜癌组织和正常子宫内膜组织的单指数模型、双指数模型及拉伸指数模型参数,包括标准表观扩散系数(ADC-stand)、慢速表观扩散系数(ADC-slow)、快速表观扩散系数(ADC-fast)、灌注分数(f)、扩散分布指数(DDC)和扩散异质性指数(α).采用受试者工作特性(ROC)曲线评价各参数值的阈值及诊断效能,分析两组间各参数值的差异以及同组间各参数值的相关性.结果 子宫内膜癌组的ADC-stand、ADC-slow、f、DDC及α值均低于子宫内膜正常组,差异均有统计学意义(P＜0.05),ADC-fast值差异无统计学意义(P＞0.05);ADC-stand和ADC-slow的ROC曲线下面积分别为0.949和0.911,阈值分别为1.245× 10-3 mm2/s、0.998×10-3 mm2/s.子宫内膜癌组的ADC-stand与ADC-slow、DDC值均呈正相关(r=0.787、0.880,P＜0.05),且ADC-slow值均低于ADC-stand值(P＜0.05).结论 单指数、双指数及拉伸指数模型部分参数的差异能够为子宫内膜癌的诊断提供新的思路.