【摘要】 目的:初步探讨DWI检查时表观扩散系数(ADC)值对局限于宫腔的子宫内膜癌与常见宫腔良性病变的鉴别诊断价值。方法:对32例经手术病理证实为局限于宫腔的子宫内膜癌和19例经分段诊刮病理检查证实为宫腔的良性病变(内膜增生12例、内膜息肉7例)的患者行常规MRI和DWI检查(b=1000 s/mm2),经后处理获得ADC图,测量并比较子宫内膜癌与宫腔良性病变的ADC值。结果:在DWI上所有子宫内膜癌呈明显高信号,而绝大多数宫腔良性病变呈高信号或稍高信号;子宫内膜癌的ADC值[(0.978±0.185)×10-3mm2/s]明显低于良性病变[(1.423±0.189)×10-3mm2/s],两者差异有极显著性意义(P=0.0064)。结论:ADC值的测量有助于鉴别常见的宫腔良恶性病变,DWI与常规MRI序列相结合能为子宫内膜癌的鉴别诊断提供更多的诊断信息,是常规MRI的有益补充。更多还原

【Abstract】 Objective:To evaluate the diagnostic accuracy of apparent diffusion coefficient(ADC) measurement in differentiating endometrial carcinomas limited to the endometrium from common benign uterine endometrial cavity lesions.Methods:Study population included 32 consecutive patients with surgically proven uterine endometrial carcinomas limited to the endometrium,19 patients proven benign diseases of endometrium(including 12 endometrial hyperplasia and 7 endometrial polyp) with dilation and curettage.All patients underwent conventional MRI series and axial diffusion-weighted imaging(DWI) with b values of 0,1000s/mm2.ADC maps were obtained by post-processing from workstations.The ADC values of endometrial carcinoma were compared with those of hyperplasia and polyp of endometrium,and a P<0.05 was considered statistically significant.Results:All endometrial carcinoma exhibited obviously high signal intensity on DWI,whereas endometrial hyperplasia and polyp showed high or slightly high signal intensity compared with normal outer myometrium.The ADC values of endometrial carcinoma(0.978±0.185)×10-3mm2/s were significantly lower(P=0.0059) than those of endometrial hyperplasia and polyp(1.423±0.189)×10-3mm2/s.Conclusion:The measurement of ADC values is helpful for differentiating malignant from benign uterine endometrial cavity lesions.DWI can provide more potential information for differential diagnosis of endometrial carcinoma and this technique should be applied in the clinical area as a rapid addition to existing routine uterus MRI protocols.更多还原