【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。更多还原

【Abstract】 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 AW4.5Workstation 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） × 10⁹ mm²/s,0.20±0.08 and 0.28±0.08,0.05±0.05and 0.09±0.07,344.22±66.19 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=0.174）.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.更多还原