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目的通过定量分析子宫腺肌症病人的MR信号强度变化,预测由子宫动脉栓塞(UAE)后发生的完全性坏死。方法回顾性分析119例子宫腺肌症伴发UAE病人的MR影像。将全部病例按MRI所示的病变位置及形态分类,测量每一子宫腺肌症病变的厚度及信号强度,并在矢状T2WI像上测量直肌的厚度及信号强度,最后计算T2加权信号强度率(T2SR)。通过单因素和多因素分析,将对不同病人的MRI参数与UAE发生后所造成的完全及不完全坏死所显示的全部反应进行对比。通过ROC曲线分析评价以MRI参数区分完全与不完全反应的预测诊断能力。结果子宫腺肌症病人UAE发生后所致的完全坏死率为66.4%(79/119),经单因素和多因素分析结果显示T2SR与完全性坏死高度相关(P=0.012)。存在症状,同时T2SR>0.475的子宫腺肌症病人与UAE后发生完全性坏死具有相关性,其敏感度为57.0%,特异度为70.0%,ROC曲线下面积(AUC)为0.643。结论通过分析T2SR值的变化,MRI可为子宫腺肌症病人发生UAE后早期治疗反应提供有意义的预测诊断。
Objective To predict the complete necrosis after uterine arterial embolism (UAE) by quantitatively analyzing the changes of MR signal intensity in patients with adenomyosis. Methods The MR images of 119 cases of adenomyosis with UAE were retrospectively analyzed. All patients were classified according to the location and morphology of the lesion as shown by MRI, the thickness and signal intensity of each adenomyosis were measured, and the thickness and signal intensity of rectus muscle were measured on the sagittal T2WI image. Finally, T2 weighted signal intensity Rate (T2SR). Through univariate and multivariate analysis, the MRI parameters of different patients were compared with those of complete and incomplete necrosis caused by UAE. ROC curve analysis was used to evaluate the predictive ability to diagnose complete and incomplete responses with MRI parameters. Results The complete necrosis rate of UAE in patients with adenomyosis was 66.4% (79/119). Univariate and multivariate analysis showed that T2SR was highly correlated with complete necrosis (P = 0.012). The patients with adenomyosis with T2SR> 0.475 had a correlation with complete necrosis after UAE. The sensitivity and specificity were 57.0% and 70.0%, respectively. The area under the curve of ROC (AUC) was 0.643. Conclusion By analyzing the changes of T2SR value, MRI can provide meaningful predictive diagnosis for early treatment response of patients with adenomyosis after UAE.