Tamai Ken, Koyama Takashi, Saga Tsuneo, Umeoka Shigeaki, Mikami Yoshiki, Fujii Shingo, Togashi Kaori
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Magn Reson Imaging. 2007 Sep;26(3):682-7. doi: 10.1002/jmri.20997.
To determine the feasibility of diffusion-weighted (DW) MRI of uterine endometrial cancer and to investigate whether the apparent diffusion coefficient (ADC) values of endometrial cancer differ from those of normal endometrium and whether they differ according to the histologic grade of the tumor.
Study population included 18 consecutive females with surgically proven endometrial cancer and 12 females with pathologically confirmed normal endometrium in cervical cancer patients. Visual evaluation and ADC measurement were performed in endometrial cancer and normal endometrium.
All endometrial cancer and the normal endometrium appeared hyperintense on DW images. The mean ADC value (10(-3) mm(2)/second) of endometrial cancer was 0.88 +/- 0.16, which was significantly lower (P < 0.01) than that of normal endometrium (1.53 +/- 0.10). The mean ADC value for each histologic grade was 0.93 +/- 0.16 (G1), 0.92 +/- 0.13 (G2), and 0.73 +/- 0.09 (G3).
The present study showed that DW imaging is feasible in demonstrating uterine endometrial cancer and ADC measurement has a potential ability to differentiate between normal and cancerous tissue of the endometrium. The ADC values of endometrial cancers of higher grade show tendency to decrease compared to those of lower grade, although estimation of histologic grade based on ADC values seems difficult because of considerable overlap.
确定扩散加权磁共振成像(DW MRI)用于子宫内膜癌成像的可行性,并研究子宫内膜癌的表观扩散系数(ADC)值是否与正常子宫内膜不同,以及是否根据肿瘤的组织学分级而有所差异。
研究对象包括18例经手术证实为子宫内膜癌的连续女性患者,以及12例宫颈癌患者中经病理证实为正常子宫内膜的女性。对子宫内膜癌和正常子宫内膜进行了视觉评估和ADC测量。
在DW图像上,所有子宫内膜癌和正常子宫内膜均呈高信号。子宫内膜癌的平均ADC值(10⁻³mm²/秒)为0.88±0.16,显著低于正常子宫内膜(1.53±0.10)(P<0.01)。各组织学分级的平均ADC值分别为0.93±0.16(G1级)、0.92±0.13(G2级)和0.73±0.09(G3级)。
本研究表明,DW成像可用于显示子宫内膜癌,ADC测量有可能区分子宫内膜的正常组织和癌组织。尽管由于存在相当大的重叠,基于ADC值估计组织学分级似乎很困难,但高级别子宫内膜癌的ADC值与低级别相比有降低的趋势。