3.0T扩散加权成像鉴别子宫内膜恶性肿瘤与良性病变  

A preliminary study on distinguishing endometrial malignant tumors form benign lesions by Diffusion Weighted Imaging at 3.0Tesla MR

作　　者：胡喜斌[1] 白雪琴[1] 孙新海[1] 李娴[1] 盛华强[1] 徐洁[1] 

机构地区：[1]济宁医学院附属医院,山东济宁272029

出　　处：《济宁医学院学报》2013年第3期192-194,197,共4页Journal of Jining Medical University

摘　　要：目的探讨3.0T磁共振DWI对子宫内膜恶性肿瘤与良性病变的鉴别诊断价值。方法 41例子宫内膜恶性肿瘤和良性病变进行常规MRI及DWI检查(b值=800s/mm2),通过DWI图拟合出ADC图,选取ROI并测量其ADC值。结果不同性质子宫内膜病变组的DWI信号虽有一定特点,但无特异性。恶性病变组和良性病变组的平均ADC值分别为(0.713±0.100)×10-3 mm2/s及(1.223±0.225)×10-3 mm2/s,两者差异存在统计学意义(t=7.623,P<0.01),ADC值鉴别子宫内膜良恶性病变的最佳诊断阈值为(0.826±0.185)×10-3mm2/s。其敏感性和特异性分别为83.5%和76.4%。子宫内膜癌的平均ADC值为(0.727±0.102)×10-3mm2/s,内膜肉瘤的平均ADC值为(0.654±0.065)×10-3 mm2/s,两者差异无统计学意义(t=0.239,P>0.05)。结论 ADC值有助于子宫内膜良恶性病变的鉴别诊断,DWI结合常规MRI序列可准确显示肌层侵犯情况及盆腔淋巴结转移情况,有望成为一种具有临床实用价值的诊断方法。Objective To investigate the role of diffusion weighted imaging（DWI）in the differential diagnosis between endometrial malignant tumors and benign lesions.Methods Forty-one patients included 16 cases of endometrial benign and 25 cases of endometrial malignant lesions were enrolled in this study.Conventional MRI and DWI（diffusion fact of 0and 800s/mm2）examinations were performed at 3.0T SIEMENS MR Scanner.Signal intensity of DWI images were observed and ADC values of the lesions were measured on corresponding ADC maps.Results The signal intensity of endometrial malignant tumors and benign lesions appeared no characteristic,but the average ADC value of endometrial benign lesions was statistically higher than that of malignant tumors.The former one average ADC value was 1.223±0.225X10-3 mm2/S and the later one was 0.713±0.100X10-3 mm2/S,and there were statistical differences between endometrial benign lesions and malignant tumors（t=7.623,P0.01）.The average ADC value of endometrial cancer（0.727±0.102X10-3 mm2/S）was slightly higher than that of endometrial sarcoma,however,the differences didn＇t have statistical significance（t=0.239,P=0.1460.05）.Conclusion ADC value may play an important role in differentiating malignant from benign endometrial lesions,and DWI sequence combined with conventional MRI have high diagnostic accuracy for malignant tumor invasion and pelvic lymph-node metastasis of malignant ovarian tumors.

关 键 词：子宫内膜 弥散加权成像 表观扩散系数 

分 类 号：R737.33[医药卫生—肿瘤]