ADC值在子宫内膜癌与子宫粘膜下肌瘤鉴别诊断中的价值

目的 探讨表观扩散系数(ADC)对子宫内膜癌与子宫粘膜下肌瘤鉴别诊断的价值.方法 对经手术病理证实的19例子宫内膜癌和7例子宫粘膜下肌瘤的ADC图像进行回顾性分析,全部病例均行扩散加权成像(DWI)、常规磁共振成像(MRI)平扫,17例子宫内膜癌和5例子宫粘膜下肌瘤行增强扫描,ADC值测定将感兴趣区(ROI)置于DWI呈高信号且在ADC图上呈相对低信号部位,取病灶最小ADC值,对同一病例于髂腰肌处以同样大小ROI测量3个ADC值,取其平均值.相对ADC值(rADC)取病灶最小ADC值与髂腰肌平均ADC值的比值,对两组病例的ADC值和rADC值分别行两独立样本近似t检验和t检验.结果 子宫内膜癌测得的最小ADC值范围为0.54~0.88×10-3 mm2/s(0.72±0.09)×10-3 mm2/s],rADC值范围为0.36~0.68(0.55±0.10);子宫粘膜下肌瘤测得的最小ADC值范围为1.00~1.40×10-3mm2/s(1.18±0.16)×10-3mm2/s],rADC值范围为0.61~1.12(0.92±0.17).子宫内膜癌与子宫粘膜下肌瘤最小ADC值范围没有重叠.子宫内膜癌与子宫粘膜下肌瘤间的最小ADC值及rADC值差异均有统计学意义(t值分别为-7.301、-6.925,均P=0.000).结论 ADC值的测量可以准确鉴别子宫内膜癌与子宫粘膜下肌瘤.

Value of ADC on differential diagnosis of endometrial carcinoma from submucous myomas

Objective To evaluate the value of apparent diffusion coefficient ( ADC) on differential diagnosis of endometrial carcinoma from submucous myomas.Methods The ADC images of 19 cases of endometrial carcinomas and 7 cases of submucous myomas histologically proved were reviewed retrospectively.All patients were examined with diffusion weighted imaging ( DWI) and conventional MRI, and 17 endometrial carcinomas and 5 submucous myomas examined with enhanced MRI .Through ADC value detecting, region of interest ( ROI) were set in DWI with high signal and located at relatively low signal regions in ADC map.The minimum ADC value of the lesion was sampled.The average of three ADC values measured with the same size of ROI at psoas of the same case was recorded.The relative ADC value ( rADC) was the ratio between the minimum ADC value and average ADC value at psoas.The ADC values and rADC values in two groups were compared with independent samples by using t'-test and t-test.Results The range of minimum ADC values on endometrial carcinomas and submucous myomas were 0.54-0.88 ×10 -3 mm2/s (0.72 ±0.09) ×10 -3 mm2/s] and 1.00 -1.40 ×10 -3 mm2/s (1.18 ±0.16) ×10-3mm2/s] respectively, and the range of rADC values were 0.36-0.68(0.55 ±0.10) and 0.61-1.12 (0.92 ± 0.17) respectively.There was no overlap in minimum ADC values between endometrial carcinomas and submucous myomas.ADC and rADC values were statistically different between endometrial carcinomas and submucous myomas ( t value was -7.301 and -6.925, respectively, both P=0.000).Conclusion Assessment of ADC values can differentially diagnose endometrial carcinomas from submucous myomas accurately.