PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to explore the value of apparent diffusion coefficient (ADC) histogram based on whole lesion volume in distinguishing stage IA endometrial carcinoma from the endometrial polyp.
METHODS: MRI of 108 patients with endometrial lesions confirmed by pathology were retrospectively analysed, including 65 cases of stage IA endometrial carcinoma and 43 cases of endometrial polyp. The volumetric ADC histogram metrics and general imaging features were evaluated and measured simultaneously. All the features were compared between the 2 groups. The receiver operating characteristic curve was utilized to evaluate the diagnostic performance.
RESULTS: The mean, max, min, and percentiles (10th, 25th, 50th, 75th, 95th) ADC values of endometrial carcinoma were significantly lower than that of polyp (all P < .05). The skewness and kurtosis of ADC values in the endometrial carcinoma group were significantly higher than those in the endometrial polyp group, and the variance of ADC values in the endometrial carcinoma group was lower than those in the endometrial polyp group (all P < .05). Endometrial carcinoma demonstrated more obvious myometrial invasion combined with intralesion haemorrhage than polyp (all P < .05). The 25th percentile of ADC values achieved the largest areas under the curve (0.861) among all the ADC histogram metrics and general imaging features, and the sensitivity and specificity were 83.08% and 76.74%, with the cut-off value of 1.01 × 10-3 mm2/s.
CONCLUSIONS: The volumetric ADC histogram analysis was an effective method in differentiating endometrial carcinoma from an endometrial polyp. The 25th percentile of ADC values has satisfactory performance for detecting malignancy in the endometrium.
CONCLUSIONS: The ADC histogram metric based on whole lesion is a promising imaging-maker in differentiating endometrial benign and malignant lesions.
METHODS: MRI of 108 patients with endometrial lesions confirmed by pathology were retrospectively analysed, including 65 cases of stage IA endometrial carcinoma and 43 cases of endometrial polyp. The volumetric ADC histogram metrics and general imaging features were evaluated and measured simultaneously. All the features were compared between the 2 groups. The receiver operating characteristic curve was utilized to evaluate the diagnostic performance.
RESULTS: The mean, max, min, and percentiles (10th, 25th, 50th, 75th, 95th) ADC values of endometrial carcinoma were significantly lower than that of polyp (all P < .05). The skewness and kurtosis of ADC values in the endometrial carcinoma group were significantly higher than those in the endometrial polyp group, and the variance of ADC values in the endometrial carcinoma group was lower than those in the endometrial polyp group (all P < .05). Endometrial carcinoma demonstrated more obvious myometrial invasion combined with intralesion haemorrhage than polyp (all P < .05). The 25th percentile of ADC values achieved the largest areas under the curve (0.861) among all the ADC histogram metrics and general imaging features, and the sensitivity and specificity were 83.08% and 76.74%, with the cut-off value of 1.01 × 10-3 mm2/s.
CONCLUSIONS: The volumetric ADC histogram analysis was an effective method in differentiating endometrial carcinoma from an endometrial polyp. The 25th percentile of ADC values has satisfactory performance for detecting malignancy in the endometrium.
CONCLUSIONS: The ADC histogram metric based on whole lesion is a promising imaging-maker in differentiating endometrial benign and malignant lesions.
摘要：
目的：本研究旨在探讨基于全病灶体积的ADC直方图在区分IA期子宫内膜癌和子宫内膜息肉中的价值。
方法：回顾性分析108例经病理证实的子宫内膜病变的MR图像。其中IA期子宫内膜癌65例,子宫内膜息肉43例。同时评估和测量体积ADC直方图度量和一般成像特征。比较两组的各项特征。受试者工作特征曲线（ROC）用于评估诊断性能。
结果：平均值，max,min,和百分位数(第十，25日,50岁，75,第95位)子宫内膜癌的ADC值显著低于息肉(均P<0.05)。子宫内膜癌组ADC值的偏度和峰度明显高于子宫内膜息肉组,子宫内膜癌组ADC值的方差均低于子宫内膜息肉组(均P<0.05)。子宫内膜癌肌层浸润合并病灶内出血较息肉明显(均P<0.05)。在所有ADC直方图指标和一般成像特征中，ADC值的第25百分位数达到最大AUC（0.861），敏感性和特异性分别为83.08%和76.74%,截止值为1.01×10-3mm2/s。
结论：体积ADC直方图分析是区分子宫内膜癌和子宫内膜息肉的有效方法。ADC值的第25百分位数对于检测子宫内膜中的恶性肿瘤具有令人满意的性能。
结论：基于整个病变的ADC直方图度量在区分子宫内膜良性和恶性病变方面是一种有前途的成像标记。
方法：回顾性分析108例经病理证实的子宫内膜病变的MR图像。其中IA期子宫内膜癌65例,子宫内膜息肉43例。同时评估和测量体积ADC直方图度量和一般成像特征。比较两组的各项特征。受试者工作特征曲线（ROC）用于评估诊断性能。
结果：平均值，max,min,和百分位数(第十，25日,50岁，75,第95位)子宫内膜癌的ADC值显著低于息肉(均P<0.05)。子宫内膜癌组ADC值的偏度和峰度明显高于子宫内膜息肉组,子宫内膜癌组ADC值的方差均低于子宫内膜息肉组(均P<0.05)。子宫内膜癌肌层浸润合并病灶内出血较息肉明显(均P<0.05)。在所有ADC直方图指标和一般成像特征中，ADC值的第25百分位数达到最大AUC（0.861），敏感性和特异性分别为83.08%和76.74%,截止值为1.01×10-3mm2/s。
结论：体积ADC直方图分析是区分子宫内膜癌和子宫内膜息肉的有效方法。ADC值的第25百分位数对于检测子宫内膜中的恶性肿瘤具有令人满意的性能。
结论：基于整个病变的ADC直方图度量在区分子宫内膜良性和恶性病变方面是一种有前途的成像标记。
