Diagnostic value and ROC curve analysis of 3.0T magnetic resonance imaging combined with thickness indexes of junctional zone in diagnosis of adenomyosis

doi:10.3969/j.issn.1002-7386.2018.09.013

Abstract：Objective To investigate the diagnostic value and ROC curve analysis of 3.0T magnetic resonance imaging combined with thickness indexes of junctional zone(JZ) in diagnosis of adenomyosis.Methods The junctional zone thickness and signal characteristics of 3.0T MRI in 51 patients with uterine adenomyosis (observation group) and 80 normal controls (control group) were retrospectively analyzed. The maximum value (JZmax) and minimum value (JZmin) of JZ thickness in T2WI were measured,and the optimal JZ thickness cut-off point of 3.0TMRI in diagnosis of uterine adenomyosis was evaluated by means of ROC curve analysis.Results Among the 51 patients with adenomyosis,JZ diffuse or localized thickening were observed,moreover the Jzmax and JZmin in observation group were significantly greater than those in control group (P<0.01).The ROC curve analysis showed that JZ thickness measurement of JZmax and JZmin had higher value in diagnosis of uterine adenomyosis,and the area under curve was 0.997,0.838,respectively,moreover,the diagnostic value of Jzmax was higher than that of JZmin,there was significant difference between them (P<0.01).In addition the optimal JZ thickness cut-off point in diagnosis of uterine adenomyosis was 10.4mm,and its sensitivity,specificity,positive predictive value,negative predictive value as well as 95% confidence interval were 98.7(93.2 ~100.0),96.1(86.5 ~99.5),97.5 (91.4~99.7),98.0(89.4 ~99.9),respectively. Among the 51 patients with adenomyosis, the small schistic T2WI high signals in thickened area were observed in 50 patients,and small schistic T1WI high signals in JZ thickened area were observed in 18 patients.However no abnormal signals were found in 80 subjects in control group,with relatively uniform T2WI low signals. Conclusion The 3. 0 T MRI can show the changes of JZ thickness and signals in patients with uterine adenomyosis,and the optimized cutoff point of JZ thickness in diagnosis of uterine adenomyosis can be obtained through ROC curve analysis.