子宫内膜癌与正常子宫的DWI对照研究

A CONTROL STUDY OF DIFFUSION-WEIGHTED IMAGING IN NORMAL UTERUS AND ENDOMETRIAL CARCINOMA

目的探讨MR弥散加权成像(DWI)在正常子宫和子宫内膜癌(EC)中的表现特征。方法对25例子宫正常者和16例经病理证实的EC病人,进行常规MRI扫描及子宫横断面DWI扫描(b=1 000s/mm2)。分别测量正常子宫的三层结构和EC病灶的弥散信号强度,分别计算ADC值,并进行比较。结果正常子宫三层结构的弥散图像信号强度内膜最高,肌层最低,结合带与肌层的差异肉眼不能分辨。ADC值肌层>内膜>结合带,差异有显著性(F=38.153,q=2.971～11.248,P<0.05)。EC病灶弥散图像信号强度高于正常子宫内膜,ADC值低于正常子宫内膜,差异均有统计学意义(t=4.196、3.538,P<0.05)。结论正常子宫三层结构MR扩散能力存在较明显差异,内膜扩散信号最好,结合带ADC值最低。弥散加权图像有利于突出显示EC病灶,ADC值测量对于弥散图像信号与正常子宫内膜相仿的EC病灶有一定鉴别价值。

Objective To explore the features of normal uterus and eadometrial carcinoma （EC） on MR diffusion weigh- ted imaging （DWI）. Methods Routine MRI and cross-section DWI （b=1000 s/mm2） of the uterus were conducted in 25 fe male volunteers and 16 patients with EC confirmed pathologically. The signal intensity （SI） on diffusion images of three layered structure of the normal uterus and EC focus were measured, and apparent diffusion coefficient （ADC） value calculated and comL pared. Results The SI of endomembrane was stronger than that of muscular layer in three-layered structure of the normal ute- rus, the difference between junctional zone （JZ） and myometrium was unable to identify with naked eye. The ADC value of the three-layered structure was that myometrium the highest, followed by endometrium, and J Z, the weakest, being statistically dif- ferent among them （F=38.153,q=2.971-11.248,P〈20.05）. The SI of diffuse picture in EC was higher than that in normalen- dometrium, and the ADC was lower （t=4. 196,3. 538;P〈0.05）. Conclusion There is a significant difference among three la- yers of normal uterus in term of MR diffusing capacity, endometrium being the highest, and JZ, the lowest. DWI is of a definite value in differential diagnosis between normal endometrium and EC that has a similar diffuse image signal.