Hu Qing, Jiang Peipei, Feng Yongjing, Zhou Nan, Chen Weibo, Zhu Li, Hu Yali, Zhou Zhengyang
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
Abdom Radiol (NY). 2022 Apr;47(4):1448-1456. doi: 10.1007/s00261-022-03413-8. Epub 2022 Feb 3.
To investigate the feasibility of using diffusion kurtosis imaging (DKI) for the assessment of endometrial fibrosis.
40 patients with hysteroscopy confirmed endometrial fibrosis and 30 healthy women underwent MR examination including the DKI sequence (b = 0, 500, 1000, 1500, and 2000 s/mm). Endometrial thickness (ET), apparent diffusion coefficient (ADC), corrected ADC (D), and kurtosis of diffusion (K) were measured and compared, and the diagnostic performance of those parameters was evaluated using ROC curves analysis.
Patients with endometrial fibrosis had a thinner endometrium than the healthy controls (P < 0.001). They also had significantly lower ADC and D values and significantly higher K values of the endometrium than the healthy controls (all P < 0.001). ADC, D, K, and ET all performed excellently in diagnosing endometrial fibrosis, with areas under the curve (AUCs) of 0.940, 0.879, 0.860, and 0.853, respectively. ADC showed the highest AUC, demonstrating better diagnostic accuracy than K (z = 2.307, P < 0.05). However, there were no differences in AUC between D, K, and ET, or ADC, D, and ET (all P > 0.05). The reproducibility of ADC, D, and K values in patients with endometrial fibrosis and healthy controls was excellent (ICC 0.951-0.991).
DKI of the endometrium has promising potential for the noninvasive assessment of endometrial fibrosis.
探讨采用扩散峰度成像（DKI）评估子宫内膜纤维化的可行性。
40例经宫腔镜证实为子宫内膜纤维化的患者和30例健康女性接受了磁共振检查，包括DKI序列（b = 0、500、1000、1500和2000 s/mm²）。测量并比较子宫内膜厚度（ET）、表观扩散系数（ADC）、校正后的ADC（D）和扩散峰度（K），并使用ROC曲线分析评估这些参数的诊断性能。
子宫内膜纤维化患者的子宫内膜比健康对照组薄（P < 0.001）。与健康对照组相比，他们的子宫内膜ADC和D值也显著更低，而K值显著更高（均P < 0.001）。ADC、D、K和ET在诊断子宫内膜纤维化方面均表现出色，曲线下面积（AUC）分别为0.940、0.879、0.860和0.853。ADC显示出最高的AUC，其诊断准确性优于K（z = 2.307，P < 0.05）。然而，D、K和ET之间或ADC、D和ET之间的AUC没有差异（均P > 0.05）。子宫内膜纤维化患者和健康对照组中ADC、D和K值的可重复性极佳（ICC 0.951 - 0.991）。
子宫内膜DKI在无创评估子宫内膜纤维化方面具有广阔的潜力。
