子宫肌瘤患者子宫正常区域的表观弥散系数研究

目的研究子宫肌瘤患者子宫正常区域各分区结构（内膜、结合带、肌层）表观弥散系数（ADC）特点及其随月经周期的变化趋势。方法 31例具有正常月经周期的子宫肌瘤患者,分为分泌期（17例）和增殖期（14例）两组。行子宫横断面DWI（b值为0、700s/mm2）扫描,分别测量子宫内膜、结合带和肌层ADC值,分析子宫分区结构ADC值差异及月经周期对其影响。结果分泌期组,子宫三层分区结构ADC值两两之间有明显统计学差异（F=104.279,p〈0.001）。增殖期组,内膜和肌层ADC值之间无统计学差别;结合带ADC值均小于内膜、肌层ADC值,有明显统计学差异（P〈0.001）。肌层ADC值在分泌期组（1.726±0.210×10^-3mm^2/s）和增殖期组（1.550±0.128×10^-3mm^2/s）有统计学差异（t=2.729,p〈0.05）;内膜在分泌期组和增殖期组比较,以及结合带在分泌期组和增殖期组比较,均无统计学差异。结论具有正常月经周期的子宫肌瘤患者子宫体部正常区域ADC值受到解剖分区结构及月经周期的影响。同时,内膜及结合带ADC值在增殖期和分泌期无统计学差异,可能与子宫肌瘤患者性激素分泌异常相关。

A Preliminary Study on Normal Area of Uterus in Fibroid Patients by Using Apparent Diffusion Coefifcients

Objective To investigate the characteristics and changes of apparent diffusion coefficient（ADC） value of the normal uterine zonal structures（epithelium, junctional zone, and myometrium） of fibroid patients during the menstrual cycle. Methods The study included 31 fibroid patients in reproductive age and each with regular cycle, divided into secretory phase group（17 cases） and proliferative phase group（14 cases）. Diffusion weighted imaging（DWI） was performed along the axial plane, using b value of 0 and 700s/mm2. The uterine ADC values of different zonal structures in different phases of the menstrual cycle were compared by statistic analysis with ANOVA, LSD, and t test. Results Results The ADC values among each uterine zonal structures were significantly different from another in secretory phase group（F=104.279,p〈0.001）; whereas in proliferative phase group, the ADC valuse between epithelium and myometrium were no significantly different, and there were significant difference in ADC values between junctional zone and other two zones（p〈0.001）. The ADC values of myometrium were significantly different（t=2.729,p〈0.05） between secretory phase group（1.726±0.210×10^-3mm^2/s） and proliferative phase group（1.550±0.128×10^-3mm^2/s）. Conclusiononclusion An obvious ADC values variation in normal area of uterus in fibroid patients because of the deferences influence from uterus zonal structures and menstrual cycle. No significace differences between the epithelium and junction zone in secretory and proliferation phase may be in result of inappropriate antidiuretic hormone in fibroid patients.