子宫肌瘤磁共振扩散张量成像特征的初步研究  

Preliminary study of magnetic resonance diffusion tensor characteristics of uterine fibroids

作　　者：邵显敏 高珊珊[1] 辛建英[1] 门永超 王锡臻[1] 孙西河[1] 王滨[2] 

机构地区：[1]潍坊医学院附属医院影像中心,山东潍坊280031 [2]滨州医学院影像医学与核医学系

出　　处：《实用放射学杂志》2016年第2期236-238,254,共4页Journal of Practical Radiology

基　　金：基金项目：国家自然科学基金项目（81171303,30470518）;山东省自然科学基金（ZR2009CL046,ZR2010HQ029）;山东省优秀中青年科学家科研奖励基金（BS2012YY038）;山东省卫生厅科技发展项目（2011HZ00I,2011HW067）;潍坊市科技发展项目（20130167,20112091）;潍坊医学院附属医院科技创新基金（K12QCL040）.

摘　　要：目的：分析子宫肌瘤和正常子宫肌层磁共振扩散张量成像（DTI）的影像特征,探讨 DTI 在评估子宫肌瘤结构的应用价值。方法研究对象为经手术病理证实的44例子宫肌瘤患者,DTI 采用双梯度 GE HDxt 3.0T 和 HD Cardiac 线圈,应用 GE AW4.5工作站进行数据处理。记录子宫肌瘤和正常子宫肌层的表观扩散系数（ADC）、各向异性分数（FA）值、容积比各向异性（VRA）值和 T2-weighted trace 值,绘制扩散张量的纤维示踪图像（DTT）。对比不同感兴趣区（ROI）的成像指标差异。结果正常子宫肌层和子宫肌瘤的 ADC、FA、VRA、T2-weighted trace 平均值分别为（1.65±0.32）×10^-9 mm2/s 和（1.21±0.97）×10^-9 mm2/s、0.20±0.08和0.28±0.08、0.05±0.05 和0.09±0.07、344.22±66.19和318.97±98.48。正常子宫肌层 ADC 值高于子宫肌瘤（P =0.009）。正常子宫肌层的 FA 和 VRA 低于子宫肌瘤（P =0.000、P =0.005）。2组的 T2-weighted trace 值差异无统计学意义（P =0.174）。DTI 纤维示踪图显示正常子宫肌层和子宫肌瘤的纤维方向、排列和数量存在明显的差异。结论 DTI 能够反映出正常子宫肌层和子宫肌瘤的微观结构差异,有助于提高 MRI 对子宫肌瘤的影像学评估的应用价值。Objective To evaluate the value of diffusion tensor imaging （DTI）in the assessment of uterine fibroids by analyzing uterine fibroids and normal myometrium.Methods Forty-four patients with uterine fibroids confirmed by surgery were included in this study.DTI was performed using double gradient GE HDxt 3.0T and HD Cardiac coil.All data were transferred to GE AW4.5 Workstation software for data processing.Apparent diffusion coefficient（ADC）,fractional aniso（FA）,volume ratio aniso（VRA）and T2-weighted trace of uterine fibroids and normal myometrium were recorded.Diffusion tensor tractography （DTT）of uterine fibroids and normal myometrium were reconstructed and observed.The ADC,FA,VRA and T2-weighted trace of different regions of interest （ROI）were compared between uterine fibroids and normal myometrium.Results The ADC,FA,VRA and T2-weighted trace of uterine fibroids and normal myometrium were （1.65±0.32）×10 -9 mm2/s and （1.21±0.97）×10 -9 mm2/s,0.20±0.08 and 0.28±0.08,0.05 ± 0.05 and 0.09±0.07,344.22±66.1 9 and 318.97±98.48,respectively.The ADC of normal myometrium was higher than that of uterine fibroids （P =0.009）.The FA and VRA of normal myometrium were lower than those of uterine fibroids （P =0.000,P =0.005）. There was no statistically significant difference of T2-weighted trace between uterine fibroids and normal myometrium （P =0.1 74）. There were obvious differences between uterine fibroids and normal myometrium in direction,arrangement and number of fibers. Conclusion DTI can be used to evaluate the structure difference between uterine fibroids and normal myometrium,which has the potential to improve assessment value of MRI for uterine fibroids.

关 键 词：子宫肌瘤 磁共振成像 纤维示踪成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]