DTI纤维示踪成像应用于活体子宫肌瘤的可行性研究

Feasibility of applying DTI fibre tractography in uterine fibroid in vivo

目的:探讨磁共振扩散张量成像(MR diffusion tensor imaging,DTI)纤维示踪成像在活体子宫肌瘤应用的可行性,比较普通型与非普通型子宫肌瘤相关DTI参数指标有无差异。方法:将24例子宫肌瘤患者行常规MRI平扫及DTI扫描,共36个子宫肌瘤,测量肌瘤的表观扩散系数(apparent diffusion coefficient,ADC)值、部分各项异性(fractional anisotropy,FA)值、纤维束密度、最长纤维束长度及平均纤维束长度。应用独立样本t检验进行普通型(21个)与非普通型(15个)2组子宫肌瘤间各测量指标的比较。结果:所有子宫肌瘤均获得较满意的纤维束重建图像,普通型子宫肌瘤的ADC值明显低于非普通型[普通型:(1.479±0.214)×10-3 mm2/s,非普通型:(1.706±0.308)×10-3 mm2/s,P=0.013]、FA值则明显高于非普通型(普通型:0.317±0.085,非普通型:0.261±0.053,P=0.031)、纤维束密度无统计学差异(普通型:130.524±56.549条/ml、非普通型:137.333±43.483条/ml,P=0.699)、最长纤维束长度及纤维束平均长度与肌瘤最大直径的比值均是普通型肌瘤明显高于非普通型(普通型:1.405±0.418、0.318±0.090;非普通型:0.983±0.247、0.210±0.060,P=0.001、0.000)。结论:DTI纤维示踪技术重建的子宫肌瘤纤维束是可行的,普通型与非普通型两组不同病理类型子宫肌瘤的ADC值、FA值及纤维束长度存在统计学差异,与镜下表现相一致。

Objecth, e：To explore the feasibility of applying MR diffusion tensor imaging（DTl） fibre tractography in uterine fibroids in vivo, and to compare the difference of related DTI measurements between the ordinary and extraordinary uterine fibroids. Methods： Routine MRI scanning and DTI scan at a 3.0T MRI scanner was performed on 24 patients with 36 uterine fibroids. The apparent diffusion coefficient （ADC） value, fractional anisotropy （FA） value, density of fiber bundle,length of the longest frbre bundle and the average length of fibre bundles were measured and collected. The comparison of all data between the ordinary（n=21 ） and extraordinary uter- ine fibroids（n=15） were analyzed using independent-samples t-test. Results：Satisfactory reconstruction images of all uterine fibreids were obtained,and the ADC values were significant lower in ordinary fibroids than in extraordinary ones[ordinary： （1.479 ± 0.214） x 10-3 mm2/s, extraordinary：（ 1.706 ±0.308） x 10-3 mm2/s, P=0.013]. FA values were significantly higher in ordinary fibroids than in ex2 traordinary ones （ordinary： 0.317 ± 0.085, extraordinary： 0.261 ± 0.053, P=0.031 ） ;the density of fiber bundles between two types of u- terine fibroids had no significant difference[ordinary： （130524 ± 56.549） striphnl,extraordinary： （137.333 ± 43.483） strip/ml,P=0.699], the ratio between the length of the longest fibre bundle or the average length of fibre bundles against the largest diameter of fibroids in ordinary fibroids were significant larger than that of extraordinary ones （ordinary： 1.405 ± 0.418,0.318 4- 0.090,extraordinary：0.983 ± 0.247,0.210 ± 0.060,P=0.001,0.000）. Conclusion：DTI fiber technology applied in reconstructing fiber bundles of uterine fibroids is feasible. The ADC values, FA values,length of fibre bundles of fibroids of different pathological types are significantly different and are consistent with the microscopic appearance.