Department of Radiology, Jeju National University Hospital, Jejudo, Republic of Korea.
J Vasc Interv Radiol. 2013 Sep;24(9):1361-5. doi: 10.1016/j.jvir.2013.05.054. Epub 2013 Jul 23.
To determine the utility of the apparent diffusion coefficient (ADC) of uterine leiomyoma for prediction of the potential response to uterine artery embolization (UAE).
This prospective study included 49 patients with uterine leiomyomas who underwent diffusion-weighted magnetic resonance (MR) imaging before UAE between May 2011 and January 2012. All patients also underwent 3-month follow-up MR imaging after UAE. Using conventional and diffusion-weighted MR imaging sequences, 72 uterine leiomyomas ≥ 3 cm were prospectively evaluated. The volume of each leiomyoma was calculated, and quantitative measurement of ADC was performed. Regression analysis was used to evaluate the relationship between ADC and volumetric response after UAE. Receiver operating characteristic curve analysis was performed to determine the sensitivity and specificity of ADC for prediction of the potential response to UAE. Interclass correlation coefficient analysis was used to assess interobserver variability between two radiologists.
Volume reduction rates of leiomyomas after UAE ranged from 0.2%-89.1% (mean, 44.1%). ADC ranged from 0.559 × 10(-3) mm(2)/s to 1.814 × 10(-3) mm(2)/s (mean, 1.170 × 10(-3) mm(2)/s). ADC was statistically significantly related to volumetric response of leiomyomas (P = .014). Using a threshold of 1.092 × 10(-3) mm(2)/s, the sensitivity and specificity of ADC for prediction of > 50% volume reduction of the leiomyoma after UAE were 82.6% and 52.3%, respectively. Using a threshold of 1.023 × 10(-3) mm(2)/s, the sensitivity and specificity of ADC for prediction of < 30% volume reduction were 80.8% and 33.3%, respectively. The interclass correlation coefficient for measuring ADC of uterine leiomyomas between two radiologists was 0.98.
ADC of uterine leiomyomas was significantly related to the volume reduction after UAE. ADC may be useful in predicting the potential response to UAE. A high ADC of the uterine leiomyoma may be associated with a greater volume reduction after UAE.
探讨子宫平滑肌瘤表观扩散系数（ADC）值预测子宫动脉栓塞术（UAE）疗效的价值。
本研究为前瞻性研究，纳入 2011 年 5 月至 2012 年 1 月期间行 UAE 治疗的 49 例子宫平滑肌瘤患者，所有患者术前均行弥散加权 MRI 检查，术后 3 个月行 MRI 随访。使用常规及弥散加权 MRI 序列对 72 个直径≥3cm 的子宫平滑肌瘤进行前瞻性评估，计算肌瘤体积并测量 ADC 值。采用回归分析评估 ADC 值与 UAE 术后肌瘤体积缩小率的相关性，绘制受试者工作特征曲线分析 ADC 值预测 UAE 疗效的敏感度和特异度，采用组内相关系数分析两位观察者间 ADC 值测量的一致性。
UAE 术后肌瘤体积缩小率为 0.2%89.1%（平均 44.1%），ADC 值为 0.559×10(-3)mm(2)/s1.814×10(-3)mm(2)/s（平均 1.170×10(-3)mm(2)/s）。ADC 值与肌瘤体积缩小率呈显著相关（P=0.014）。以 ADC 值 1.092×10(-3)mm(2)/s 为截断值，其预测 UAE 术后肌瘤体积缩小率＞50%的敏感度和特异度分别为 82.6%和 52.3%，以 ADC 值 1.023×10(-3)mm(2)/s 为截断值，其预测肌瘤体积缩小率＜30%的敏感度和特异度分别为 80.8%和 33.3%。两位观察者间测量 ADC 值的组内相关系数为 0.98。
子宫平滑肌瘤 ADC 值与 UAE 术后肌瘤体积缩小率密切相关，有助于预测 UAE 疗效，高 ADC 值可能与 UAE 术后肌瘤体积缩小率较高相关。
