DTI及DTT在评估Ⅰ期子宫内膜癌肌层浸润深度的价值  

The value of DTI and DTT in the depth of myometrial invasion of endometrial cancer stageⅠ

作　　者：程启超 王燕鸣 李菲 辛建英 沈蓁[1] 王锡臻[1] 王滨[2] CHENG Qichao;WANG Yanming;LI Fei;XIN Jianying;SHEN Zhen;WANG Xizhen;WANG Bin(School of Medical Imaging,Imaging Center of Affiliated Hospital,Weifang Medical University,Weifang 261053,China;Binzhou Medical University,Institute of Medical Imaging,Yantai 264033,China)

机构地区：[1]潍坊医学院医学影像学院潍坊医学院附属医院影像中心,潍坊261053 [2]滨州医学院医学影像研究所,烟台264033

出　　处：《磁共振成像》2020年第7期497-500,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：山东省自然科学基金(编号:ZR2017MH037);山东省医药卫生科技发展计划(编号:2017WS408、2017WS579);潍坊市科技发展计划项目(编号:2017YX054)。

摘　　要：目的通过比较子宫内膜癌(endometrial cancer,EC)Ⅰa期、Ⅰb期,以及正常肌层的扩散张量成像(diffusion tensor imaging,DTI)参数值差异,探讨DTI及扩散张量纤维束(diffusion tensor tractography,DTT)在Ⅰ期EC肌层浸润深度的诊断价值。材料与方法分析40例EC患者及同年龄段23名正常女性盆腔磁共振平扫(magnetic resonance imaging,MRI)及DTI检查资料。采用ADW 4.5工作站分析感兴趣区(region of interest,ROI)的平均表观弥散系数(apparent diffusion coefficient,ADC)值、部分各向异性分数(fractional anisotropy,FA)值、各向异性容积比(volume ratio anisotropy,VRA)值及T2-weighted trace(T2-WT)值,并重建DTT。比较DTI参数在Ⅰa期、Ⅰb期EC,以及与正常肌层间的差异,观察受侵肌层DTT纤维束走形情况。结果Ⅰa期27例,Ⅰb期13例。Ⅰb期ADC值低于Ⅰa期(t=-3.141,P=0.003),FA值与T2-WT值均高于Ⅰa期(t=2.767、2.947,P=0.009、0.006),差异具有统计学意义;Ⅰb期VRA值高于Ⅰa期,但差异无统计学意义(P>0.05)。EC较正常肌层相比,ADC值降低(t=-12.141,P=0.000);VRA值及T2-WT值增加(t=2.523、8.582,P=0.014、0.000),FA值差异无统计学意义(P>0.05)。DTT示受侵肌层纤维束明显减少,排列紊乱,部分中断。结论DTI不同参数及重建DTT对Ⅰ期EC肌层浸润深度判断具有一定价值,可作为判断EC肌层浸润深度的辅助诊断指标。Objective:The study aimed to evaluate endometrial cancer(EC)stageⅠdiagnostic value by comparing the diffusion tensor imaging(DTI)parameters and diffusion tensor tractography(DTT)of endometrial cancer stageⅠa andⅠb,normal myometrium.Materials and Methods:Analyzed the conventional magnetic resonance imaging(MRI)and DTI examination of 40 cases pathologically confirmed endometrial cancer patients and 23 cases normal women.ADW 4.5 station to record the region of interest(ROI)average apparent diffusion coefficient(ADC)value,fractional anisotropy(FA)value,volume ratio anisotropy(VRA)value,and T2-weighted trace(T2-WT)value,and rebuilt DTT.Compared the differences DTI parameters among endometrial cancer stageⅠa andⅠb,normal myometrium.Results:Endometrial cancerⅠa andⅠb were 27 and 13 respectively.The ADC value of endometrial cancer stageⅠb was lower than stageⅠa(t=-3.141,P=0.003),FA valve and VRA valve were higher than stageⅠa(t=2.767,2.947;P=0.009,0.006),there was no statistically significant of VRA value(P>0.05).Compared with the myometrium,the ADC value was lower(t=-12.141,P=0.000),VRA value and T2-WT value were higher(t=2.523,8.582;P=0.014,0.000),there was no statistical difference of FA value between stageⅠendometrial cancer and myometrium(P>0.05).DTT showed that the myometrium fibers of the endometrial cancer were decreased,the arrangement was disordered and irregular and interrupted.Conclusions:DTI parameters and DTT can reflect the microscopic changes to endometrial cancer stage diagnosis,and can be used as an auxiliary diagnosis method in the depth of myometrial invasion.

关 键 词：子宫内膜肿瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]