磁共振扩散加权成像在子宫内膜病变鉴别诊断中的价值

目的探讨磁共振扩散加权成像(DWI)以及表观扩散系数(ADC)在子宫内膜癌、子宫内膜增生、子宫内膜息肉及子宫黏膜下肌瘤变性鉴别诊断中的价值。方法收集经病理证实的子宫内膜癌25例、子宫内膜增生6例、子宫内膜息肉4例、子宫黏膜下肌瘤变性1例,所有病例行常规MRI及DWI检查,测量并比较所有子宫内膜病变的ADC值。结果 25例子宫内膜癌在DWI上均呈明显高信号,平均ADC值为(0.78±0.06)×10-3mm2/s;6例子宫内膜增生在DWI呈略高信号,平均ADC值为(1.41±0.12)×10-3mm2/s;4例子宫内膜息肉在DWI呈略高信号,平均ADC值为(1.33±0.07)×10-3mm2/s,1例子宫黏膜下肌瘤在DWI呈等信号,ADC值为(2.19±0.25)×10-3mm2/s。子宫内膜增生与子宫内膜息肉ADC值比较无统计学差异(P>0.05),其余两两比较均有统计学差异(P<0.05)。结论 DWI与ADC值能有效区分子宫内膜病变的水分子扩散差别,对诊断及鉴别诊断具有重要价值。

Value of Diffusion-weighted MRI Imaging in Differential Diagnosis of Uterine Endometrial Lesions

Objective To investigate the value of diffusion-weighted imaging(DWl) and apparent diffusion coefficient(ADC) in the differentiation of endometrial carcinomas,endometrial hyperplasia and endometrial polyps and degeneration of uterine sub mucous.Methods Conventional MRI and DWI were preformed in 25 patients with endometrial carcinomas,6 patients with endometrial hyperplasia,4 patients with endometrial polyps and 1 patients with degeneration of uterine sub mucous.All images were reviewed and apparent diffusion coefficient(ADC) values were measured in all the lesions shown in all endometrial lesions.Results High signal intensity in DWI was showed in 25 cases of endometrial carcinomas,and the mean ADC value was(0.78±0.06)×10-3mm2/s.6 cases of endometrial hyperplasia had slightly high signal in DWI,and the average ADC value was(1.41 ± 0.12) ×10-3mm2/s.4 cases of endometrial polyps in DWI had slightly high signal,and the average ADC value was(1.33±0.07)×10-3mm2/s.1 cases of degeneration of uterine sub mucous in DWI had the signals,and the ADC value was(2.19±0.25)×10-3mm2/s.There was no statistically significant difference between endometrial hyperplasia and endometrial polyps is ADC value(P>0.05),and the remaining had statistically significant differences(P<0.05).Conclusions DWI and ADC value can effectively reflect the diffusion properties of water in different lesions.So it has great value in the differentiation all endometrial lesions.