Accuracy Of Different Apparent Diffusion Coefficients In Diagnosis Of Uterine Sarcoma And Atypical Uterine Leiomyoma

PurposeTo investigate the diagnostic accuracy of different ADC values for uterine sarcoma and atypical uterine leiomyoma,and to establish the best diagnostic model for Combining different ADC values.MethodsFrom June 2011 to December 2016,all patients with pathologically confirmed uterine sarcoma or atypical uterine leiomyoma underwent routine 3T MRI examination before operation.The values of mADC,minADC and rADC were measured and recorded in all patients.The difference and diagnostic efficacy of ADC values between the two groups were analyzed and compared.Multivariate logistic regression diagnostic model was established by incorporating three ADC values,and ROC curve was used to evaluate the diagnostic efficiency of diagnostic model in differential diagnosis the uterine sarcoma and atypical uterine leiomyoma.ResultsThe values of mADC,minADC and rADC had statistical significance in differential diagnosis of uterine sarcoma and atypical uterine leiomyoma(P<0.00).when the threshold value of mADC was 1.21*10~-33 mm~2/s,sensitivity is 88.6%,specificity is 84.1%,accuracy is 86.6%,positive predictive value is 43.0%,negative predictive value is 47%.When the threshold value of minADC was 0.95*10~-33 mm~2/s,sensitivity is 87.3%,specificity is 87.3%,accuracy is 86.6%,positive predictive value is 44.0%,negative predictive value is 53.0%.When the rADC value was0.59,sensitivity is 89.9%,specificity is 69.8%,accuracy is 81.0%,positive predictive value is 37.0%,negative predictive value is 22.0%.According to multivariate logistic regression,mADC value and minADC value can be selected as independent factors of diagnostic model.Evaluating diagnostic efficiency of diagnostic model based on ROC curve,the AUC is 0.907(95%confidence interval is 0.850-0.965),sensitivity is 97.5%,specificity is 82.5%,accuracy is 91.5%,positive predictive value is 40.0%,negative predictive value is 17.0%.ConclusionAll three ADC values can be used to differentiate and diagnose uterine sarcoma and atypical uterine leiomyoma.The diagnostic accuracy of mADC value and minADC value is not significantly different.When combined with the value of mADC and minADC,the diagnostic accuracy is the highest.