绝经前女性正常宫颈组织的表观弥散系数值研究

Study on apparent diffusion coefficients of normal uterus cervix in premenopausal women

目的探讨不同年龄段绝经前女性正常宫颈组织在不同生理周期的表观弥散系数值（apparent diffusion coef ficient,，ADC）变化。方法将82名健康女性按年龄段分成3组（A组27例，20～29岁；B组28例，30～39岁；C组27例，40～49岁），采用3．0TMRl分别于增殖中期及分泌中期行2次盆腔MR检查，研究不同结构区、年龄段及生理周期的宫颈ADC值的变化。结果子宫3层结构的ADC值两两比较差异均有统计学意义（肌层最高，黏膜层居中，结合带最低），宫颈黏膜层及结合带的ADC值在分泌中期均低于增殖中期，而肌层的ADC值在不同周期问差异不明显，宫颈每层结构在同一周期的各年龄组之间无明显差异，宫颈粘膜层在增殖中期的ADC值更为稳定。结论不同结构区及生理周期会对正常宫颈组织的ADC值产生影响，当利用ADC值探测早期宫颈癌、监测疗效及鉴别肿瘤早期复发时应考虑这些因素，绝经前女性应在增殖期行盆腔MR扫描。

Objective To investigate the apparent diffusion coefficients （ADCs） of the normal uterine cervical zonal structures （cervical epithelium, junctional zone and myometrium） during different phases of the menstrual cycle among premenopausal women in different age groups. Methods Eighty two healthy women, who were divided into three age groups （group A, 27 women in their twenties; group B, 28 women in their thirties; group C, 27 women in their forties）, underwent 3 T magnetic resonance imaging （MRI） with T2-weighted and diffusion-weighted imaging （DWI） during the mid-proliferative and the mid-secretory phases. The ADC values of cervix in different zonal structures, ages and phases of the menstrual cycle were compared. Results The ADC values of each cervical zonal structures were significantly different from one another （the ADCs of myometrium were highest and those for junctional zone were lowest, （ P 〈0. 001）. The ADC values of epithelium and junctional zone were both lower during the mid secretory phase than those during the mid proliferative phase in each age groups （ P〈0.05）. No statistical difference in ADC values of myometrium was observed in the comparison between the mid proliferative phase and the mid-secretory phase in each age groups. There were no signifi cant differencs in the ADC values of any cervical zones among the three age groups for a given phase, the ADCs of epitheli um were tend to be more stable during the mid- proliferative phase when compared with the mid-secretory phase. Conclu sion The ADC values of normal cervix change with different zone and phases of the menstrual cycle should be taken into consideration when we detect early cervical pathologies, monitor treatment response and differentiate tumor early recur rence. Premenopausal women should undergo pelvic MRI scan during the proliferative phase.