正常子宫内膜和子宫内膜癌的扩散加权成像特点

目的探讨子宫内膜癌、子宫内膜不同周期及病理状态下的扩散加权成像的特点,研究表观扩散系数(ADC)及相对表观扩散系数(rADC)在子宫内膜癌的鉴别诊断应用价值。方法对29例子宫内膜癌,9例子宫内膜良性病变者和26例正常对照者行1.5T MRI检查并进行ADC值的测定(b值为800s/mm2)。闭孔内肌作参比部位,测量正常子宫内膜及内膜癌的rADC值,将不同组别ADC、rADC值相比较,进行统计学分析。结果子宫内膜癌ADC、rADC值分别为〔(0.96±0.22)×10-3 mm2/s、0.72±0.22〕,显著低于正常子宫内膜的ADC、rADC值〔(1.39±0.27)×10-3 mm2/s、1.02±0.22〕和子宫内膜良性病变ADC、rADC值〔(1.33±0.18)×10-3 mm2/s、1.02±0.28〕。萎缩期子宫内膜ADC、rADC值〔(1.62±0.37)×10-3 mm2/s、1.16±0.27〕显著高于增生期〔(1.29±0.14)×10-3 mm2/s、0.98±0.19〕和分泌期内膜〔(1.27±0.12)×10-3 mm2/s、0.94±0.12〕。结论 ADC有潜力鉴别子宫良性病变与子宫内膜癌,以闭孔内肌作为参比部位,所获得的rADC值可以很好的反映子宫内膜癌及正常子宫的扩散特征。

Diffusion-weighted MR imaging of uterine endometrial cancer and normal endometrium

Objective To determine the feasibility of diffusion-weighted（DW） MRI of uterine endometrial cancer and to investigate whether the apparent diffusion coefficient（ADC） values and the relative apparent diffusion coefficient（rADC） of endometrial cancer differed from those of normal endometrium and benign endometrial leisions（Internal obturator muscle as the reference site）.Methods Study population included 29 females with surgically proven endometrial cancer and 9 females with pathologically confirmed benign endometrial lesions and 26 patients with normal endometrium.ADC and rADC measurement were performed in endometrial cancer and normal endometrium with 1.5 T MR（Internal obturator muscle as the reference site）,and compared the ADC and rADC value between two groups.Results All endometrial cancer and the normal endometrium appeared hyperintense on DW images.The mean ADC value and the mean rADC value of endometrial cancer were（（0.96±0.22）×10-3mm2/s and（0.72±0.22））,which were significantly lower（P0.01） than those of normal endometrium（（1.39±0.27） ×10-3mm2/s and（1.02±0.22））,lower than those of benign endometrial disease（（1.33±0.18）×10-3mm2/s and（1.02±0.28））.The mean ADC value and the mean rADC value for each type of normal endometrium were（1.29±0.14）×10-3mm2/s and（0.98±0.19）（hyperplasia type）,（1.27±0.12）×10-3mm2/s and（0.94±0.12）（secrete type）,and（1.62±0.37）×10-3mm2/s and（0.98±0.19）（atrophic type）.The mean ADC and rADC value of atrophic type were higher than those of hyperplasia and secrete type normal endometrium.Conclusion The present study shows that DWI is feasible in demonstrating uterine endometrial cancer and ADC and rADC measurement（Internal obturator muscle as the reference site） has a potential ability to differentiate between normal and cancerous tissue of the endometrium.