中国临床医学影像杂志2026，Vol.37Issue(5)：342-346,5.DOI:10.12117/jccmi.2026.05.009
APTw及DCE-MRI对Ⅰ期子宫内膜癌和子宫内膜息肉的鉴别价值
The value of using APTw imaging and DCE-MRI to differentiate stage Ⅰ endometrial carcinoma from endometrial polyps
摘要
Abstract
Objective:To investigate the diagnostic value of amide proton transfer-weighted(APTw)imaging and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in differentiating stage Ⅰ endometrial cancer(EC)from endometrial polyps(EP).Materials and Methods:A retrospective analysis was conducted on 36 patients with stage Ⅰ EC and 19 patients with EP confirmed by surgical pathology who underwent 3.0T MRI scans between April 2019 and January 2022.The scanning sequences included sagittal APTw and DCE-MRI(40 phases).Clinical information of the patients was recorded,and ΔMTRasym(3.5 ppm)value and DCE-MRI parameters(Ktrans,Kep,Ve,and Vp)were measured.Differences in clinical information and quan-titative parameters between the EC and EP groups were compared.The diagnostic performance of each parameter was evaluat-ed using receiver operating characteristic(ROC)curves.A combined diagnostic model(Model)was established using binary Lo-gistic regression.The area under the curve(AUC)differences between independent parameters and the combined model were compared using the DeLong test.The correlation between the differential parameters of the two sequences was analyzed using the correlation coefficient.Results:There were statistically significant differences in age,menopausal status,abnormal uterine bleeding(AUB),and human epididymis protein4(HE4)levels between the two groups(P<0.05).No significant differences were found in lesion location,shape,signal on conventional sequences,or CA125 levels(P>0.05 for all).The ΔMTRasym(3.5 ppm),Ktrans,Kep,and Vp values were higher in the EC group than in the EP group,while the Ve value was lower in the EC group.ΔMTRasym(3.5 ppm)value and Kep were independent factors for differentiating EC from EP(P<0.05).The AUC of the combined Model(0.937)was higher than that of ΔMTRasym(3.5 ppm)alone(0.775,P=0.008),but there was no significant difference in AUC between the Model and Kep(0.917,P=0.256).There was no significant difference between the AUCs of ΔMTRasym(3.5 ppm)and Kep(P=0.052).ΔMTRasym(3.5 ppm)showed weak correlation with Ktrans and Kep,with correlation coefficients(r)of 0.392 and 0.417,respectively(P=0.022 and P=0.002).Conclusion:Both APTw and DCE-MRI can effectively differentiate EC from EP,and their combination can improve diagnostic efficacy,showing good clinical application prospects.关键词
子宫内膜肿瘤/息肉/磁共振成像Key words
Endometrial Neoplasms/Polyps/Magnetic Resonance Imaging分类
医药卫生引用本文复制引用
李烨,刘爱连,卢绪论,田士峰,宋清伟,林良杰,王家正..APTw及DCE-MRI对Ⅰ期子宫内膜癌和子宫内膜息肉的鉴别价值[J].中国临床医学影像杂志,2026,37(5):342-346,5.基金项目
2023年大连市医学科学研究计划项目(医学登峰计划)(编号:2023DF038). （医学登峰计划）
