Quantitative MRI of uterine leiomyomas during triptorelin treatment: Reproducibility of volume assessment and predictability of treatment response
Quantitative MRI of uterine leiomyomas during triptorelin treatment: Reproducibility of volume assessment and predictability of treatment response
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DOI：
10.1016/s0730-725x(96)00231-7
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发表时间：
1996-01-01
影响因子：
2.5
通讯作者：
Schoemaker, J
中科院分区：
文献类型：
--
作者：
Broekmans, FJ;Heitbrink, MA;Schoemaker, J
磁共振（MR）成像越来越多地应用于子宫平滑肌瘤的定量评价，与超声（US）技术相比，MR被认为更准确，MR信号强度（SI）可预测肌瘤对GnRH激动剂治疗的反应，本研究旨在评价平行平面MR方法测量子宫体积的精确性和基于椭圆体公式的准确性还试图分析MR平滑肌瘤体积测量的精确性，并检查治疗前肌瘤SI模式与激动剂治疗反应之间的关系。27名患有肌瘤的妇女在GnRH激动剂治疗6个月期间扫描三次，T-1加权和T-2加权，以及在横向和矢状面获得子宫的T-1对比增强序列，使用传统扇形扫描仪进行子宫腹部US，通过使用软件系统分析MR获得的三维图像，通过平行平面法（MR-ROI）以及使用椭圆体公式（MR-ELL）测量子宫体积，通过MR-ROI方法评估肌瘤体积，从选定的组织样本以及从感兴趣的完整肌瘤区域估计肌瘤的SI，通过腹部US，通过椭圆体公式（US-ELL）评估体积，根据方差分析获得的均方计算观察者内和观察者间和方法可靠性（Rw/Rb）。对于子宫体积评估，当分析MR-ROI和MR-ELL方法时，观察者间和方法间的可靠性非常好。对于US-ELL测量，观察者间可靠性有限。此外，以MR-ROI法为标准时，US-ELL的可靠性较低。使用MR-ROI方法评估肌瘤体积显示观察者间和方法间高度一致。肌瘤/脂肪SI比率和平均SI变异系数未能显示与个体肌瘤对曲普瑞林治疗的反应程度相关，在MR子宫体积评估中，与更复杂的MR-ROI方法相比，MR-ELL方法非常准确，MR和US之间的一致性有限，因此，MR图像上的椭圆体方法被认为是用于定量评估对激素治疗的子宫体积反应的选择方法，子宫肌瘤SI模式被证明在预测子宫肌瘤对GnRH激动剂治疗的反应方面没有价值。版权所有（C）1996 Elsevier Science Inc.
Magnetic resonance (MR) imaging is increasingly applied for the quantitative evaluation of uterine leiomyomas, MR is thought to be more accurate in comparison to ultrasound (US) techniques, MR signal intensity (SI) may prove to be predictive of myoma response to GnRH agonist treatment, This study aimed to evaluate the precision of uterine volume assessment by a parallel planimetric MR method and the accuracy of the ellipsoid formula based calculations from MR and US images, It was also attempted to analyze the precision of MR leiomyoma volume measurements and examine the relation between pretreatment myoma SI patterns and the response to agonist therapy, Twenty-seven women with a myomatous uterus were scanned three times during GnRH agonist treatment for 6 months, T-1- and T-2-weighted, as well as T-1 contrast-enhanced sequences of the uterus were obtained in the transverse and sagittal plane, Abdominal US of the uterus was performed with a conventional sector scanner, By the use of a software system for analysis of three-dimensional images obtained by MR, uterine volume was measured by a parallel planimetric method (MR-ROI) as well as the use of the ellipsoid formula (MR-ELL), Myoma volume was assessed by the MR-ROI method, SI of the myomas was estimated from selected tissue samples as well as from the integral myoma region of interest, By abdominal US, volume was assessed by the ellipsoid equation (US-ELL), Within- and between-observer and method reliability (Rw/Rb) was calculated from mean squares obtained by analysis of variance, For uterine volume assessment, reliability between observers and between methods when the MR-ROI and MR-ELL methods were analyzed was excellent, For the US-ELL measurements, the between-observer reliability was limited, Moreover, the reliability of the US-ELL was low when the MR-ROI method was used as the standard. Myoma volume assessment with the MR-ROI method showed high between-observer and between-method agreement. The myoma/fat SI ratio and the mean SI coefficient of variation failed to show a correlation with the degree of response to triptorelin treatment of individual myomas, In MR uterine volume assessment the MR-ELL method is very accurate compared with the more complicated MR-ROI method, The agreement between MR and US is limited, Therefore, the ellipsoid method on MR images is to be regarded as the method of choice for quantitative assessment of uterine volume response to hormonal treatment, Myoma SI patterns were shown to be of no value in the response prediction of myomas to treatment with GnRH agonists. Copyright (C) 1996 Elsevier Science Inc.