APTw及DCE-MRI对Ⅰ期子宫内膜癌和子宫内膜息肉的鉴别价值OA

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.