不同分化程度子宫内膜癌表观扩散系数与DCE-MRI定量参数的关系

The relationship between apparent diffusion coefficient and DCE-MRI parameters in endometrial carcinoma with different degrees of differentiation

目的:探究不同分化程度的子宫内膜癌表观扩散系数(apparent diffusion coefficient,ADC)与磁共振动态增强扫描成像(dynamic contrast enhanced MRI,DCE-MRI)定量参数之间的关系。方法:回顾性分析2016年10月至2018年10月于我院就诊的子宫内膜癌患者90例。根据临床病理资料将其分为低分化组(18例)、中分化组(52例)和高分化组(20例),分析各组的DCE-MRI及弥散加权成像(diffusion weighted imaging,DWI)图像,测量ADC mean值和DCE-MRI相关参数K^(trans)、V_(e)、K_(ep)值并分析其相关性。结果:在不同分化程度的子宫内膜癌中,ADC_(mean)、K^(trans)、V_(e)和K_(ep)值均存在显著差异(P<0.05);中、低分化组的ADC_(mean)值与K^(trans)、V_(e)和K_(ep)值呈负相关(P<0.05),且随着分化程度降低,相关性增加(r低,K^(trans)=-0.612;r低,V e=-1.313;r低,K ep=-0.568)。结论:不同分化程度子宫内膜癌的ADC_(mean)、K^(trans)、V_(e)和K_(ep)存在显著差异,中、低分化组的ADC_(mean)与K^(trans)、V_(e)和K_(ep)呈负相关,且随着分化程度降低,相关性增强,为子宫内膜癌的术前分化等级诊断提供了参考依据。

Objective:To investigate the relationship between apparent diffusion coefficient(ADC)and quantitative parameters of dynamic contrast enhanced MRI(DCE-MRI)in endometrial carcinoma with different degrees of differentiation.Methods:90 endometrial cancer patients in our hospital from October 2016 to October 2018 were retrospectively analyzed.According to the clinical pathology information,patients were divided into low-differentiation group(18 cases),medium-differentiation group(52 cases)and high-differentiation group(20 cases).DCE-MRI and diffusion weighted imaging(DWI)images of each group were analyzed,and the mean value of ADC as well as DCE-MRI related parameters K^(trans),V_(e) and K_(ep) values were measured and further analyzed for their correlation.Results:ADC mean,K trans,V_(e) and K_(ep) values were significantly different in endometrial carcinoma with degrees of different differentiation(P<0.05).ADC mean values in the medium-and low-differentiation groups were negatively correlated with K^(trans),V_(e) and K_(ep) values(P<0.05),and the correlation enhanced along with the decrease of differentiation degree(r low,K trans=-0.612,r low,V_(e)=-1.313,r low,K_(ep)=-0.568).Conclusion:There are significant differences in ADC mean,K^(trans),V_(e) and K_(ep) indifferent differentiation endometrial carcinoma.ADC mean in the medium-and low-differentiation groups is negatively correlated with K^(trans),V_(e) and K_(ep).Moreover,the correlation is enhanced with the decrease of differentiation degree.These findings provide a basis for the preoperative differentiation grade diagnosis of endometrial cancer.