【摘要】 【目的】探讨3.0T磁共振弥散加权成像在女性盆腔恶性肿瘤的病变范围及转移中的临床应用价值。【方法】回顾性分析26例女性盆腔恶性肿瘤的MRI影像学资料,并与手术病理资料对照。病例包括宫颈癌17例(术前14例,术后复发3例)、子宫内膜癌7例(术前5例,术后复发2例)、结肠癌术后复发1例、卵巢癌术后复发1例。进行女性盆腔恶性病变与正常组织(闭孔内肌)ADC值的测量与比较,以及常规MR成像组和弥散成像结合常规MR成像组的病变观察结果的比较。【结果】①女性盆腔恶性病变与正常组织ADC值测量与比较:女性盆腔恶性肿瘤原发灶、转移灶与闭孔内肌的ADC值三者间比较差异有统计学意义(P=0.024);原发灶与闭孔内肌ADC值比较差异有统计学意义(P=0.012);闭孔内肌与转移灶ADC值比较差异有统计学意义(P=0.021);原发灶与转移灶的ADC值比较差异无统计学意义(P=0.402)。②常规MR成像组和弥散成像结合常规MR成像组的病变观察结果的比较:常规MR成像组与弥散成像结合常规MR成像组发现病变分别为43处及88处,两组发现病灶数目差异有统计学意义(P<0.001)。【结论】3.0T磁共振弥散加权图像ADC值测量能够定量反映病灶的弥散受限程度,有助于鉴别盆腔良恶性病变。背景抑制磁共振弥散加权成像分辨率高,能清晰直观地显示女性盆腔恶性病变的范围和转移,具有良好的临床应用价值。更多还原

【Abstract】 【Objective】 To evaluate clinical value of diffusion weighted 3.0T MR imaging in detecting lesions and metastasis in malignant tumors of female pelvic. 【Methods】 3.0T MR imaging of 26 female patients with malignant masses of pelvic were retrospectively analyzed, including 17 cervix carcinoma (14 preoperative and 3 recurrence of postoperative), 7 endometrial cancer (5 preoperative and 2 recurrence of postoperative), 1 colon cancer (recurrence of postoperative), and 1 ovarian cancer (recurrence of postoperative). Apparent diffusion coefficient (ADC) of all the primarily lesions and metastasis were measured and compared with the ADC of normal tissue (internal obturator muscle). Conventional 3.0T MRI and DWI combined with conventional MRI were compared in detecting lesions. 【Results】 1) Measurement and comparison of the ADC value of malignant lesions and normal tissue: the difference was statistically significant among the primarily lesions, metastasis and internal obturator muscle(P = 0.024). The difference was statistically significant between the primarily lesions and internal obturator muscle (P = 0.012). The difference was statistically significant between the metastasis and internal obturator muscle (P = 0.021). The difference was not statistically significant between the primarily lesions and metastasis (P = 0.402). 2) Comparison of the ability of the conventional 3.0T MRI and DWI combined with conventional MRI in detecting malignant lesions: there were 43 and 88 lesions detected by conventional MR group and DWI combined with conventional MR group respectively. The difference was statistically significant between the two groups (P < 0.001). 【Conclusion】 The ADC value of the diffusion weighted 3.0T MRI could reflect the diffusion limited of the lesions quantitatively, and identify the benign and malignant lesions. Diffusion weighted imaging with background suppression could display the malignant lesions in female pelvic clearly and directly with the high resolution and high clinical value.更多还原