相对表观扩散系数值在子宫内膜病变中的诊断价值

Relative apparent doff asion coefficient in the diagnostic value of endometrial lesions

目的研究表观扩散系数(ADC)及相对表观扩散系数(r ADC)在子宫内膜良、恶性病变中的鉴别诊断应用价值。方法对24例子宫内膜癌,15例子宫内膜良性病变者和17例正常对照者行1.5 T磁共振成像检查并进行ADC值的测定(b值为800 s/mm2)。闭孔内肌作参比部位,分别测量子宫内膜癌、子宫内膜良性病变及正常分泌期子宫内膜的ADC值及r ADC值。将不同组别ADC、r ADC值相比较,进行统计学分析。结果子宫内膜癌ADC、r ADC值分别为(0.56±0.13)×103 mm2/s、0.65±0.12,显著低于正常子宫内膜的ADC、r ADC值(1.03±0.09)×103mm2/s、1.02±0.1和子宫内膜良性病变ADC、r ADC值(0.99±0.04)×103 mm2/s、1.1±0.16。利用ROC曲线对r ADC值进行分析,子宫内膜癌组与子宫内膜良性病变组相比较,曲线下面积为0.96,子宫内膜癌组与正常子宫分泌期组相比较,曲线下面积为0.93。结论 ADC值有潜力鉴别子宫良性病变与子宫内膜癌。以闭孔内肌作为参比部位,所获得的r ADC值可以很好地反映子宫内膜癌及子宫内膜良性病变的扩散特征。

Objective To investigate whether the apparent diffusion coefficient （ADC） values and the relative apparent diffusion coefficient （rADC） of endometrial cancer differed from those of normal endometrium and benign en-dometrial leisions （Internal obturator muscle as the reference site）. Methods Study population included 24 females with surgically proven endometrial cancer and 15 females with pathologically confirmed benign endometrial lesions and 17 patients with normal endometrium.ADC and rADC measurement were performed with 1.5 T MR（Internal obtu-rator muscle as the reference site）.and compared the ADC and rADC value between two groups. Results All en-dometrial cancer and the normal endometrium appeared hyperintense on DW images.The moan ADC value and the mean rADC value of endometrial cancer were （0.56±0.13）×10^3 mm^2/s、0.65±0.12. Which were significantly lower（P〈0.01） than those normal endometrium[（1.03±0.09）×10^3 mm^2/s、1.02±0.1], lower than those of benign endometrial dis-ease[（0.99±0.04）×10^3 mm^2/s、1.1±0.16]. Conclusion The prcscnt study shows that DWI is feasible in demonstrating uterine endometrial cancer and ADC and rADC measurement（Internal obturator muscle as the reference site）has a po-tential ability to differentiate between normal and cancerous tissue of the endometrium.