论文部分内容阅读
目的探讨Extended Tofts和Exchange两种模型的动态对比增强MRI(DCE-MRI)参数在鉴别细胞型子宫肌瘤中的应用价值。方法搜集2015年10月至2016年6月经手术病理证实的32例子宫肌瘤患者,术前行盆腔多期DCE-MRI,选择Extended Tofts和Exchange血流动力学模型分别计算子宫肌瘤的定量灌注参数K~(trans)、PS、Fp、K_(ep)、V_e、V_p。术后按病理分型分为细胞型、普通型、退变型3组,对比分析3组子宫肌瘤灌注参数的组间差异;筛选出有统计学意义的参数,绘制鉴别细胞型子宫肌瘤的ROC曲线;使用Pearson相关性分析观察两种模型间的参数有无相关性。结果在3组子宫肌瘤间,Extended Tofts模型中的K~(trans)、Kep、Vp及Exchange模型中的Fp、K_(ep)、V_p值差异有统计学意义(P<0.05),且这些参数在鉴别细胞型子宫肌瘤的ROC曲线下面积分别为1.000、0.923、0.827、1.000、0.702、0.738;Extended Toft模型中的K~(trans)与Exchange模型中的PS和Fp相关(r=0.365,P=0.034,r=0.968,P=0.000),K_(ep)、V_p在两种模型中呈正相关(r=0.454,P=0.007,r=0.479,P=0.004),两种模型间的Ve值无相关性。结论 Extended Tofts模型中的K~(trans)、K_(ep)、V_p及Exchange模型中的Fp、K_(ep)、V_p值在鉴别细胞型子宫肌瘤中的应用价值较高,特别是Extended Tofts模型中的K~(trans)值和Exchange模型中的Fp值诊断效能最高,且两者具有明显的相关性;同时Extended Tofts模型的K_(ep)、V_p值诊断效能优于Exchange模型。
Objective To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) parameters of Extended Tofts and Exchange in differentiating uterine fibroids. Methods Thirty-two patients with uterine fibroids confirmed by surgery and pathology from October 2015 to June 2016 were enrolled in this study. Pelvic multi-phase DCE-MRI was performed preoperatively. Extended Tofts and Exchange hemodynamic models were selected to quantify uterine leiomyoma Parameters K ~ (trans), PS, Fp, K_ (ep), V_e, V_p. According to pathological classification, the cells were divided into three groups: cell type, normal type and degenerative type. The differences of the perfusion parameters between the three groups were compared and analyzed. Statistically significant parameters were screened, and the cell type of uterine fibroids ROC curve; Pearson correlation analysis was used to observe the correlation between the two parameters. Results Among the three groups of uterine fibroids, there were significant differences in the values of Fp, K ep and V_p in K, Trans, Kep, Vp and Exchange models of Extended Tofts model (P <0.05) The area under the ROC curve for the identification of cellular uterine fibroids was 1.000, 0.923, 0.827, 1.000, 0.702, and 0.738, respectively; K trans in the Extended Toft model correlated with PS and Fp in the Exchange model (r = 0.365 , P = 0.034, r = 0.968, P = 0.000). There was a positive correlation between K ep and V p in the two models (r = 0.454, P = 0.007, r = 0.479, P = 0.004) There is no correlation between Ve value. Conclusion The values of Kp, Kp, Vp and Fp, Kp and Vp in Extended Tofts model are of high value in differentiating uterine leiomyoma, especially Extended Tofts The K trans value in the model and the Fp value in the Exchange model have the highest diagnostic efficiency, and the two have obvious correlations. Meanwhile, the K_ (ep) and V_p values of the Extended Tofts model are better than the Exchange model in diagnosis.