不同月经周期正常子宫的扩散加权成像研究

Apparent diffusion coefficient values of normal uterine structures in different age groups and menstrual cycles

目的研究正常女性不同年龄段、不同月经周期、子宫不同结构的ADC值的变化。方法使用3.0 T MRI扫描仪,行常规MRI序列及DWI扫描,其中b值为0和1000 s/mm^(2)。56例不同年龄段女性志愿者进行盆腔常规MRI和DWI扫描,测量子宫内膜、结合带、外肌层的ADC值,比较不同年龄组、不同周期子宫结构ADC值的差异。结果56例志愿者中育龄期组23例、围绝经期组15例、绝经组18例。育龄期组在排卵期和分泌中期子宫各层结构两两比较ADC值差异均有统计学意义(P<0.05),结合带ADC值低于内膜低于外肌层;绝经期组内膜与结合带、结合带与外肌层间ADC值差异有统计学意义(P<0.05);围绝经期组排卵期内膜ADC值高于育龄期组排卵期,差异有统计学意义(P<0.05);育龄期组排卵期内膜ADC值低于分泌中期,差异有统计学意义(P<0.05)。结论子宫的ADC值在不同结构、不同年龄、不同月经周期有所不同,利用ADC值分析子宫病变时应考虑这些因素的影响。

Objective To investigate the apparent diffusion coefficient(ADC)values of normal uterine structures in different age groups and menstrual cycles.Methods 56 healthy women of childbearing(23),perimenopausal(15),and postmenopausal(18)age groups underwent pelvic diffusion-weighted imaging(DWI)at b values of 0 and 1000 s/mm^(2) using a Siemens 3.0 T MRI scanner.The ADC values were measured in the endometrium,junctional zone,and outer myometrium.The ADC values in different uterine structures were compared among different age groups and menstrual cycles.Results In the childbearing age group,there were significantly different ADC values,lowest in the junctional zone and highest in the outer myometrium in the ovulation and mid-secretory periods(P<0.05).The ADC value of the endometrium in the ovulation period was significantly lower than that in the mid-secretory period(P<0.05).Perimenopausal women had significantly higher endometrial ADC value at ovulation period than that of childbearing age group(P<0.05).In the menopausal group,the ADC values were significantly different between the endometrium and junctional zone as well as between the junctional zone and outer myometrium.Conclusion The ADC values varied among different uterine structures,age groups and menstrual cycles.These factors should be considered when ADC values are used to characterize uterine lesions.