MR DCE-PWI 及 IVIM-DWI 定量绝经前后正常子宫内膜微循环改变

目的：评价磁共振动态对比增强灌注加权成像(MR DCE-PWI)及体素内不相干运动扩散加权成像(IVIM-DWI)定量绝经正常前后子宫内膜微循环变化。方法33例经手术或病理证实的子宫内膜正常的受试者(绝经前21例和绝经后12例)行 MR DCE-PWI 及 IVIM-DWI 检查,分析和比较绝经前后内膜感兴趣区(ROI)的 DCE-PWI 及 IVIM-DWI 定量参数值。结果绝经前后正常子宫内膜的 DCE-PWI 参数容积转移常数(Ktrans )分别为(0.161±0.081)min-1和(0.097±0.054)min-1、速率常数(Kep )分别为(0.285±0.145)min-1和(0.184±0.119)min-1、曲线下初始面积(IAUC60)分别为(20.854±10.695)mmol·kg-1·s 和(10.481±6.253)mmol·kg-1· s,差异均有统计学意义。IVIM-DWI 定量参数真实扩散系数(D)、假性扩散系数(D*)和灌注分数(f)值在绝经前后差异无统计学意义。结论 DCE-PWI 能定量绝经前后子宫内膜微循环的改变,IVIM-DWI 尚不能代替 DCE-PWI 评价内膜微循环的改变。

Quantifying the changes of endometrial microcirculation between pre-and postmenopause with MR DCE-PWI and IVIM-DWI

Objective To evaluate the changes of endometrial microcirculation between pre-and postmenopause with magnetic resonance dynamic contrast-enhanced perfusion weighted imaging (MR DCE-PWI)and intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI).Methods Thirty-three patients with normal endometrium (premenopause in 21 and postmenopause in 12)confirmed by pathology underwent DCE-PWI,IVIM-DWI and conventional MRI.Quantitative parameters of DCE-PWI and IVIM-DWI in the endometrium were analyzed and compared between pre-and postmenopause groups.Results The DCE-PWI parameters were significantly higher in premenopause group than those in postmenopause one with significant differences in Ktrans (0.161±0.081)min-1 vs (0.097±0.054)min-1 , Kep (0.285±0.145)min-1 vs (0.184±0.119)min-1 and IAUC60 (20.854±10.695)mmol·kg-1 ·s vs (10.481±6.253)mmol·kg-1 ·s. No significant differences were found between the two groups in IVIM-DWI parameters including D,D* and f values.Conclusion DCE-PWI,rather than IVIM-DWI,can be used to quantitatively evaluate the changes of endometrial microcirculation between pre-and postmenopause.