磁共振扩散加权成像应用于子宫肿瘤研究价值的初步探讨

Clinical application of diffusion-weighted MRI in uterine tumors-evaluation of signal intensity and ADC values

目的与常规T2WI对比,评价扩散加权成像(DWI)用于显示子宫肿瘤方面的能力及优势,比较子宫良恶性肿瘤在扩散加权图像信号强度和量化指标ADC值两方面是否有区别。方法行盆腔MRI检查的58例女患者,子宫病灶73个,经病理或随访证实良性23个,恶性50个。图像评价以信号强度比(SIR)和对比噪声比(CNR)为参数,对扩散图像和T2WI图像分组比较。对良恶性病灶间进行信号强度和ADC值比较。扩散b值为1000。结果子宫良性肿瘤DWI图像的SIR和CNR低于T2图像,子宫恶性肿瘤则反之。良、恶性两类肿瘤之间比较,DWI图像上恶性病灶的信号强度参数均高于良性组,ADC值低于良性病灶,内膜腺癌和宫颈鳞癌ADC值无显著性差异。结论与常规T2WI相比,子宫恶性肿瘤在扩散图像上更容易突出显示而易于分辨,而良性肿瘤在常规T2WI上的显示更具优势。子宫恶性肿瘤的ADC值明显低于良性肿瘤。

Objective To investigate the ability and advantage of DWI in demonstrating uterine benign and malignant tumors,and compare ADC values between these two kinds.Methods Total 73 uterine lesions of 58 patients were proved as 50 malignant and 23 benign.DWI and other sequences were acquired at 1.5T MR scanner.B value was 0 and 1000.The signal intensity ratio（SIR）and contrast to noise ratio（CNR）of the DWI and T2 images were calculated to evaluate the image quality in demonstrating lesions.The signal intensities were compared between DWI images and T2 images.Signal intensity and ADC values of DWI were compared between malignant and benign groups.Results Of benign tumors,SIR and CNR of DWI were lower than that of T2WI,with statistically significant differences.Of malignant tumors,however,both 2 parameters were higher in DWI than T2WI.All parameters of DWI in malignant group were significantly higher than that of benign.ADC value of malignant tumors was significantly lower than benign ones,but the distribution of AD C value between endometrial adenocarcinomas and cervical squamous cancers had no difference.Conclusion The relatively high signal intensity of the uterine cancers in DWI make the lesions readily and easy to be found.Compared with T2 images,DWI has a stronger ability in highlighting malignant tumors,which is an advantage of DWI in demonstrating lesions.Malignant tumors had lower ADC values than benign ones,while ADC values of endometrial adenocarcinomas and cervical squamous cancers shows no difference.