摘要
本研究通过回顾性研究2016年1月至2017年1月淮南市第一人民医院48名女性子宫内膜腔肿瘤患者病例,以探讨表观扩散系数(apparent diffusion coefficient, ADC)在子宫内膜腔肿瘤鉴别诊断中的有效性。患者分组如下:组1,子宫内膜癌患者;组2,子宫内膜息肉患者;组3,粘膜下平滑肌瘤患者;另外,A组为恶性病变患者;B组为良性病变患者。通过测量肿瘤和外肌层表观扩散系数(ADC)值并计算所有患者的肿瘤-子宫肌层表观扩散系数(ADC)比值,并通过ROC曲线(Receiver operating characteristic curve)分析确定截断值、敏感性和特异性,本研究发现,组1平均ADC值和比值低于组2和组3,组3的ADC值和比值均低于组2,组1、组2、组3的表观扩散系数(ADC)值的敏感性分别为91.6、98.9和68.4,特异性分别为82.3、87.8和58.2。组1、组2、组3的表观扩散系数(ADC)比的敏感性分别为92、98.4和66,特异性分别为77.5、95和65。A和B两组在平均肿瘤表观扩散系数(ADC)值和比值方面差异显著,ADC值的敏感性和特异性分别为91%和80.5%,ADC比的敏感性和特异性分别为90%和76.8%。本研究初步结论表明,表观扩散系数(ADC)值和比值是确定子宫内膜腔肿瘤患者肿瘤病变的重要参数。
In order to investigate the effectiveness of apparent diffusion coefficient(ADC) in the differential diagnosis of uterine endometrial cavity tumors, we retrospectively studied the cases of 48 female patients with uterine endometrial cavity tumors in The First people's Hospital of Huainan form January 2016 to January 2017 in this study. Patients were grouped as follows: Group 1, patients with endometrial cancer; Group 2, patients with endometrial polyps; Group 3, patients with submucosal leiomyoma. In addition, A group was consisted of malignant lesions patients; B group was consisted of benign lesions patients. The tumor-myometrial apparent diffusion coefficient(ADC) ratio was calculated for all patients by measuring the tumor and the apparent diffusion coefficient(ADC) values of the outer muscularis. The cut-off value, sensitivity and specificity were determined by ROC curve analysis. The results showed that the average apparent diffusion coefficient(ADC)value and the ratio of group 1 were lower than those of group 2 and group 3. The apparent diffusion coefficient(ADC) values and the ratios of group 3 were lower than those of group 2. The sensitivities of apparent diffusion coefficient(ADC) value in group 1, group 2 and group 3 were 91.6, 98.9 and 68.4, respectively, and the specificities were 82.3, 87.8 and 58.2, respectively. The sensitivities of apparent diffusion coefficient(ADC) ratio in group1, group 2 and group 3 were 92, 98.4, and 66, respectively, and the specificities were 77.5, 95, and 65,respectively. There was a significant difference between group A and B in mean tumor apparent diffusion coefficient(ADC) value and ratio. The sensitivity and specificity of apparent diffusion coefficient(ADC) value were 91% and 80.5% respectively, and the sensitivity and specificity of apparent diffusion coefficient(ADC)ratio were 90% and 76.8% respectively. The preliminary conclusions of this study indicated that ADC value and ratio might be important parameters for the diagnosis of pathological changes of uterine endometrial cavity tumors.
引文
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