子宫内膜癌的MRI动态增强特征

The Characteristics of Dynamic Contrast-enhanced MRI in Endometrial Carcinoma

目的探讨子宫内膜癌DCE-MRI的特征,为多期增强扫描的时相选择提供参考。方法选取17例术后病理证实为子宫内膜癌Ⅰ-Ⅱ期的患者作为病例组,对照组为4例子宫体部子宫肌瘤和8名女性志愿者,术前均行常规MRI平扫、DCEMRI扫描,选取感兴趣区域绘制增强的时间-信号强度曲线(TIC),计算各感兴趣区域在增强30s、60s、120s、150s时相的强化率(E),用student-t检验分析各时相强化率的差异;分析两者的时间-信号强度曲线(TIC)的特征。结果子宫内膜癌在增强早期轻度强化,与正常子宫肌层强化率的差异无统计学意义(P>0.05),与子宫肌瘤强化率的差异有统计学意义(P<0.05),增强中晚期(30-150s)子宫内膜癌强化率与对照组均有差异(P<0.05)。子宫内膜癌与正常肌层差异在晚期(120-150s)最大,与子宫肌瘤组差异在增强早期末段(20-30s)最大。17例子宫内膜癌,其中15例TIC呈Ⅰ型,2例TIC呈Ⅱ型;对照组TIC绝大部分呈Ⅲ、Ⅳ、Ⅴ型。结论 DCE-MRI能反映子宫内膜癌血流动力学变化,结合TIC,重点观察中晚期(60-150s)时间段内子宫内膜癌信号变化及强化率,有助子宫内膜癌的诊断及分期。

Objective To explore The characteristics of dynamic contrast-enhanced MRI（DEC-MRI） in endometrial carcinoma, to provide reference to nmlti-phase contrast-enhanced scan. Methods Seventeen cases with endometrial carcinoma in stage Ⅰ to Ⅱ proved pathologically were served as study group, 4 cases with hysteromyoma in uterine body and 8 volunteers as control group. Plain scan and dynamic contrast-enhanced MR scan were underwent to the patients in the study group as well as the volunteers in the control group. ROI was selected and the time-intensity curve（TIC） was drawn from the DEC-MRI of ROl, ROI enhanced rate（E） were calculated respectively in 30s, 60s, 90s, 150s. Then we analyzed the differences of enhanced rate respectively with the student-test （ P〈0.05 ） between the study group and control group. Then we analyzed their TIC characteristics. Results All endometrial carcinomas showed slightly contrast-enhanced appearance in the early period. There was no significant difference in early enhanced rate between endometrial carcinomas and myonletrium of volunteers （ P〉0.05 ） , but there was significant difference between endometrial carcinomas and hysteromyoma （ P〈0.05 ） . There was difference between the study group and control group in intemlediate and late period（30-150） （P〈0.05） . There was maximum difference in late period（120-150s） between endometrial carcinomas and nlyometrium of volunteers, and in early period（20-30s） between endometrial carcinomas and hysteromyoma. In 17 cases with endometrial carcinomas, 15cases had type Ⅰ curve, 2 cases had type Ⅱ. The curves of the control group were almost belong to type Ⅲ, type Ⅳ and type Ⅴ. Conclusins DEC-MRI can reflect the change of blood dynamics of endometrial carcinoma, emphasize observing the signal change and enhanced rate in the early late period（60-150s） with the TIC , that can be useful to diagnose and make stages.