目的：探讨扩散峰度成像（DKI）定量参数直方图分析鉴别子宫癌肉瘤（UCS）和变性子宫肌瘤（DH）的价值。方法：回顾性分析经手术病理证实的11例UCS和22例DH患者的资料。患者均行盆腔DKI扫描，经后处理获得DKI定量参数，包括平均弥散峰度（MK）、平均弥散系数（MD）、各向异性分数（FA），后采用Omni-Kinetics软件进行直方图分析，获得DKI各参数的中位数、平均值、标准差、偏度、峰度、25%位数、75%位数、能量、熵等直方图参数。采用独立样本t检验（正态分布）或Mann-Whitney秩和检验（偏态分布）比较UCS和DH的各直方图参数的差异，采用ROC曲线评价有统计学差异的直方图参数对UCS和DH的鉴别效能。结果：两组间MK的标准差、75%位数、熵，MD的中位数、平均值、25%位数、75%位数，FA的中位数、平均值、标准差、25%位数、75%位数、能量、熵的差异具有统计学意义（P均<0.05）；两组间MK的中位数、平均值、偏度、峰度、25%位数、能量，MD的标准差、偏度、峰度、能量、熵，FA的偏度、峰度的差异无统计学意义（P均>0.05）；FA的中位数、75%位数的曲线ROC下面积最大（均为0.921）；FA的75%位数的敏感度最高（100.0%）；MK的标准差的特异度最高（100.0%）。结论：DKI定量参数直方图分析有助于鉴别UCS与DH。
Abstract
Objective: To evaluate the value of diffusion kurtosis imaging(DKI) quantitative parameter histogram analysis in differentiating uterine carcinosarcoma(UCS) from degenerative hysteromyoma(DH). Methods: The data of 11 patients with UCS and 22 patients with DH confirmed by operation and pathology were retrospectively analyzed. All patients underwent pelvic DKI scanning, quantitative parameters of DKI, including mean kurtosis(MK), mean diffusivity(MD), fractional anisotropy(FA), were obtained after post-processing. Histogram analysis was performed using Omni-Kinetics software, histogram parameters, such as median, average, standard deviation, skewness, kurtosis, 25th percentile, 75th percentile, energy, and entropy were obtained. The independent samples t test(normal distribution) or Mann-Whitney rank sum test(skewed distribution) were used to compare the differences of histogram parameters between UCS and DH. Receiver operator characteristic(ROC) curve was used to evaluate the effectiveness of histogram parameters with statistical differences in differential diagnosis of UCS and DH. Results: There were significant differences in MK(standard deviation, 75th percentile, entropy), MD(median, average, 25th percentile, 75th percentile), FA(median, average, standard deviation, 25th percentile, 75th percentile, energy, entropy) between the two groups(P<0.05). There were no significant differences in MK(median, average, skewness, kurtosis, 25th percentile, energy), MD(standard deviation, skewness, kurtosis, energy, entropy), FA(skewness, kurtosis) between the two groups(P>0.05). The area under ROC of FA(median, 75th percentile) was the largest(0.921). The sensitivity of FA(75th percentile) was the highest(100.0%) and the specificity of MK(standard deviation) was the highest(100.0%). Conclusion: Histogram analysis of DKI quantitative parameters is helpful to distinguish UCS from DH.
关键词
子宫肿瘤 /
平滑肌瘤 /
超声检查 /
磁共振成像
Key words
Uterine neoplasms /
Leiomyoma /
Ultrasonography /
Magnetic resonance imaging
中图分类号：
Ｒ737.33
Ｒ445.1
Ｒ445.2
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基金
首都科技领军人才培养工程（Z181100006318003）。
