磁共振扩散加权成像对子宫内膜癌的诊断价值

The Diagnostic Value of Diffusion Weighted Imaging in Endometrial Cancer

目的探讨磁共振扩散加权成像在子宫内膜癌分期中的诊断价值。方法回顾性分析56例经手术病理证实的子宫内膜癌的MRI平扫成像结合增强成像与MRI平扫结合扩散加权成像对于术前分期判断的差异,并与术后病理结果进行对照分析。同时比较正常内膜组与内膜癌组及不同分期的表观扩散系数(ADC)值的差异,从而探讨扩散加权成像对于内膜癌分期的诊断价值。结果对于内膜癌的准确分期,结合扩散加权成像后,Ⅰ期的诊断准确率提高至85.3%,Ⅱ期的诊断准确率提高至94.1%,比单纯的MRI平扫加增强成像诊断准确率明显提高。正常子宫内膜ADC值(1.44±0.10)×10-3mm2/s明显大于内膜癌ADC值(0.98±0.14)×10-3mm2/s(t=10.03,P<0.05);ADC值在内膜癌不同分期之间的比较:Ⅰ期和Ⅱ期无统计学差异(P=0.373),Ⅲ期ADC值小于Ⅰ期和Ⅱ期(P=0.001,P=0.008)。结论磁共振扩散加权成像对子宫内膜癌的术前准确分期有较高的诊断价值。

Objective Study on the diagnostic value of diffusion weighted imaging in endometrial cancer stage and dif- ferential diagnosis. Methods 56 cases of pathologically confirmed endometrial cancer patients MR data were analyzed ret- rospectively. Comparison of MRI scan imaging combined with enhanced imaging and unenhanced MR imaging combined with diffusion - weighted imaging for differences in preoperative staging diagnosis and were compared with pathological re- suits. Meanwhile compared the ADC values differences among the normal endometrium, endometrial cancer group and dif- ferent stages, so as to explore diffusion-weighted imaging for the diagnosis of endometrial cancer staging. Results For ac- curate staging of endometrial Carcinoma, combined with diffusion-weighted imaging, phase I diagnostic accuracy rate in- creased to 85.3%, II to 94.1% , diffusion-weighted imaging diagnostic accuracy increased significantly. ADC value （ 1. 44 ±0. 10） ×10-3 mm2/s in normal endometrium Carcinoma was significantly greater than the ADC value of （0.98 ± 0.14 ）× 10- 3 mm//s in endometrial cancer（ t = 10. 03, P 〈 0.05 ） ; ADC value between different stages of endometrial canc- er： phase I and phase Ⅱ no significant difference （P = 0. 373）, m stage ADC value less than the stage I and stage 1] （P = 0. 001,P = 0.008）. Conclusion Diffusion weighted imaging has a high diagnostic value in the staging of endometri- al cancer.