3.0T磁共振高b值弥散加权成像对子宫内膜癌的诊断价值研究  

Study on the diagnostic value of 3.0T magnetic resonance high b-value diffusion weighted imaging for endometrial carcinoma

作　　者：孟颖[1] 梁宇霆[1] 王新莲[1] 王克扬[1] 刘明明[1] Meng Ying;Liang Yuting;Wang Xinlian;Wang Keyang;Liu Mingming(Department of Radiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院、北京妇幼保健院放射科,北京100006

出　　处：《中国医师进修杂志》2024年第5期460-465,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨3.0T磁共振高b值弥散加权成像(DWI)对子宫内膜癌的诊断价值。方法回顾性分析118例疑诊子宫内膜病变患者的临床资料。其中,病理诊断为子宫内膜癌83例(子宫内膜癌组),复杂性或非典型增生35例(子宫内膜增生组)。另外选取同期病理诊断为子宫内膜正常患者47例(子宫内膜正常组)。患者均行3.0T MRI检查,包括常规T 2加权成像(T 2WI)和多个b值(0、300、400、600、800、1000、2000、3000和4000 s/mm 2)DWI扫描,测量不同b值子宫内膜信号强度,绘制b值-子宫内膜信号强度曲线,计算子宫内膜信号下降程度。结果当b值为300、400、600和800 s/mm 2时,三组子宫内膜信号强度比较差异无统计学意义(P>0.05);当b值为1000、2000、3000和4000 s/mm 2,子宫内膜癌组子宫内膜信号强度明显高于子宫内膜正常组和子宫内膜增生组(456.1±119.4比371.3±99.9和381.6±184.8、284.2±91.9比163.2±46.5和191.4±110.8、196.7±72.4比103.7±30.9和129.4±83.1、151.6±54.8比74.6±20.8和101.1±60.7),差异有统计学意义(P<0.05);子宫内膜正常组与子宫内膜增生组比较差异无统计学意义(P>0.05)。b值-子宫内膜信号强度曲线分析结果显示,子宫内膜癌组子宫内膜信号下降程度明显小于子宫内膜正常组和子宫内膜增生组(0.79±0.05比0.90±0.03和0.87±0.04),子宫内膜增生组明显小于子宫内膜正常组,差异有统计学意义(P<0.05)。结论高b值DWI有助于鉴别子宫内膜癌和子宫内膜良恶性病变,可提高对子宫内膜癌的定性诊断价值。Objective To investigate the diagnostic value of 3.0T magnetic resonance with high b-value diffusion weighted imaging(DWI)for endometrial carcinoma(EC).Methods The clinical data of 118 patients with suspected endometrial lesions were analyzed retrospectively.Among them,83 cases were pathologically diagnosed as EC(EC group),and 35 cases were diagnosed as complex or atypical hyperplasia(endometrial hyperplasia group).In addition,47 patients with normal endometrial(normal endometrial group)in the same period were selected.All patients underwent 3.0T MRI conventional T 2-weighted imaging(T 2WI)and multiple b-value(0,300,400,600,800,1000,2000,3000 and 4000 s/mm 2)DWI scans.The endometrial signal intensity on different b-value DWI was measured.The b-value-endometrial signal intensity curve was drawn,and the decline degree of endometrial signal intensity was calculated.ResultsWhen b-value was 300,400,600 and 800 s/mm 2,there was no significant difference in endometrial signal intensity among the three groups(P>0.05);when b-value was 1000,2000,3000 and 4000 s/mm^(2),the signal intensity in EC group was significantly higher than that in normal endometrial group and endometrial hyperplasia group(456.1±119.4 vs.371.3±99.9 and 381.6±184.8,284.2±91.9 vs.163.2±46.5 and 191.4±110.8,196.7±72.4 vs.103.7±30.9 and 129.4±83.1,151.6±54.8 vs.74.6±20.8 and 101.1±60.7),and there was statistical difference(P<0.05);while there was no significant difference between normal endometrial group and endometrial hyperplasia group(P>0.05).The results of b-value-endometrial signal intensity curve showed that the decrease of endometrial signal intensity in EC group was significantly lower than that in normal endometrial group and endometrial hyperplasia group(0.79±0.05 vs.0.90±0.03 and 0.87±0.04),the index in endometrial hyperplasia group was significantly lower than that in normal endometrial group,and there was statistical difference(P<0.05).Conclusions High b-value DWI is useful for the differentiation of benign and malignant endom

关 键 词：子宫内膜肿瘤 子宫内膜增生 弥散磁共振成像 诊断 鉴别 B值 

分 类 号：R737.33[医药卫生—肿瘤]