Quantitative Perfusion Histogram Parameters Of Dynamic Contrast-Enhanced MRI To Identify Cellular Leiomyoma

Objective:To evaluate the value of histogram parameters of dynamic contrast-enhanced MRI(DCE-MRI)in the diagnosis of cellular leiomyoma.Methods:71 patients with leiomyomas confirmed by pathology who underwent preoperative DCE-MRI between October 2015 and September 2017 were enrolled in this retrospective study.Quantitative perfusion histogram parameters(including median,mean,skewness,kurtosis,energy,entropy)were measured for each patient.Leiomyoma was divided into degeneration,ordinary and cellular type according to pathology.To comparison and analysis parameters of the three groups.One-way analysis of variance and Least significant difference were used to compare the differences among the parameters of the three groups which were normal distribution and equal variances,while Kruskal-Walls test and Mann-Whitney U test were used to compare the parameters that did not conform to normal distribution or variance.ROC curves was drawn to evaluate the diagnostic efficiency of different parameters.Results:Among the three groups,the values of Ktrans(median,mean,kurtosis,energy,entropy),Kep(median,mean,skewness,kurtosis,entropy),Ve(median,mean,skewness,kurtosis)and Vp(median,mean,skewness,kurtosis,energy,entropy)had statistical difference(all P<0.05).The values of Ktrans(median,mean),Kep(median,mean),VP(median,mean)and Ktrans(entropy)of the cellular group were higher than those of the degeneration and ordinary groups.While the values of Ktrans(kurtosis,energy)and Kep(skewness)of the cellular group were lower than the other two groups;Then the value of Kep(kurtosis)of the cellular group was lower than the ordinary group and the value of kep(entropy)of the cellular group was higher than the ordinary group;And the values of Ve(median,mean,kurtosis)and Vp(entropy)of the cellular group were higher than those of the ordinary group.The values of Ve(skewness)and Vp(skewness,kurtosis and energy)of the cellular group were lower than those of degeneration group.ROC curves for differentiating cellular leiomyoma with meaningful parameters were drawn,it was found that when Ktrans(median)was 0.994/min,its sensitivity was 100%,the specificity was 73.8%,and the area under ROC curve was 0.905;when Ktrans(mean)was 1.170/min,its sensitivity was 90%,the specificity was 85.2%,the area under ROC curve was 0.921;.And the area under ROC curve of Ktrans(kurtosis,energy,entropy),Kep(median,mean,skewness,kurtosis,entropy),Ve(median,mean,skewness),Vp(median,mean,skewness)was 0.764、0.795、0.823、0.872、0.864、0.761、0.792、0.736、0.736、0.728、0.711、0.774、0.759、0.746,respectively.Conclusion:Histogram analysis of DCE-MRI quantitative perfusion is applicable for identification of cellular leiomyoma.