Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, 610041, Sichuan, China.
Department of Ultrasound, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, 610041, Sichuan, China.
Sci Rep. 2021 Oct 6;11(1):19806. doi: 10.1038/s41598-021-99209-9.
To evaluate the "flow void" diameter in patients with pregnancy-related diseases with and without uterine AVMs and assess the diagnostic performance of unenhanced MRI for uterine AVMs. From May 2014 to April 2019, 79 patients with pregnancy-related diseases were included, including 36 with and 43 without uterine AVMs confirmed by DSA. On MRI, the diameter of the most prominent "flow void" (hereinafter referred to as fv-D) was measured and compared between patients with and without uterine AVMs. The diagnostic performance of fv-D was estimated with receiver operating characteristic curves. The "flow void" sign was observed in patients with and without uterine AVMs (P > 0.05). The fv-D was significantly larger in patients with uterine AVMs in the myometrium and parametrium than in patients without uterine AVMs (P < 0.0001). The fv-D achieved a reliable diagnostic performance in the myometrium (sensitivity 80.6%, specificity 60.5%, negative predictive value 78.8%, positive predictive value 63%, AUC 0.727, cut-off: > 1.33 mm) and parametrium (sensitivity 97.2%, specificity 67.4%, negative predictive value 96.7%, positive predictive value 71.4%, AUC 0.881, cut-off > 2.6 mm). On MRI, fv-D could diagnose uterine AVMs. The fv-D had a much higher diagnostic efficiency in the parametrium than in the myometrium. The parametrium fv-D greatly improved the diagnostic sensitivity and provides a more accurate, noninvasive method of investigating possible uterine AVMs.
评估伴有和不伴有子宫动静脉畸形（AVM）的妊娠相关疾病患者的“血流空化”直径，并评估未增强 MRI 诊断子宫 AVM 的性能。2014 年 5 月至 2019 年 4 月，纳入 79 例妊娠相关疾病患者，其中 36 例经 DSA 证实存在子宫 AVM，43 例无子宫 AVM。MRI 上测量并比较了有和无子宫 AVM 患者最明显的“血流空化”直径（以下简称 fv-D）。采用受试者工作特征曲线评估 fv-D 的诊断性能。在有和无子宫 AVM 的患者中均观察到“血流空化”征象（P＞0.05）。子宫 AVM 患者的肌层和宫旁 fv-D 明显大于无子宫 AVM 患者（P＜0.0001）。fv-D 在肌层（敏感度 80.6%，特异度 60.5%，阴性预测值 78.8%，阳性预测值 63%，AUC 0.727，截断值：＞1.33mm）和宫旁（敏感度 97.2%，特异度 67.4%，阴性预测值 96.7%，阳性预测值 71.4%，AUC 0.881，截断值＞2.6mm）均具有可靠的诊断性能。MRI 上，fv-D 可诊断子宫 AVM。fv-D 在宫旁的诊断效率明显高于肌层。宫旁 fv-D 极大地提高了诊断的敏感度，并为探查可能的子宫 AVM 提供了一种更准确、无创的方法。
