Inada Yuki, Matsuki Mitsuru, Nakai Go, Tatsugami Fuminari, Tanikake Masato, Narabayashi Isamu, Yamada Takashi, Tsuji Motomu
Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan.
Eur J Radiol. 2009 Apr;70(1):122-7. doi: 10.1016/j.ejrad.2007.11.042. Epub 2008 Jan 7.
In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images.
DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p<0.05 considered statistically significant.
In 19 of 23 patients, endometrial cancers were detected only on T2-weighted images. In the remaining 4 patients, of whom two had coexisting leiomyoma, no cancer was detected on T2-weighted images. This corresponds to an 83% detection sensitivity for the carcinomas. When DW images and fused DW images/T2-weighted images were used in addition to the T2-weighted images, cancers were identified in 3 of the remaining 4 patients in addition to the 19 patients (overall detection sensitivity of 96%). The mean ADC value of endometrial cancer (n=22) was (0.97+/-0.19)x10(-3)mm(2)/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p<0.05).
DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.
在本研究中，作者探讨了扩散加权磁共振成像（DW-MRI）在子宫子宫内膜癌检测中的可行性和价值，以及其相对于传统非增强磁共振图像的优势。
使用1.5-T磁共振扫描仪对23例子宫内膜癌患者进行DW图像检查。本研究通过与组织病理学结果对比，调查DW图像相对于传统非增强磁共振成像是否具有额外的增量价值。此外，在22例子宫内膜癌患者的感兴趣区域测量表观扩散系数（ADC）值，并与31名志愿者的正常子宫内膜、子宫肌层，14例患者的平滑肌瘤以及10例患者的子宫腺肌病的ADC值进行比较。采用Wilcoxon秩和检验，p<0.05被认为具有统计学意义。
23例患者中有19例仅在T2加权图像上检测到子宫内膜癌。其余4例患者中，2例合并平滑肌瘤，在T2加权图像上未检测到癌症。这相当于癌的检测灵敏度为83%。当除T2加权图像外还使用DW图像和融合的DW图像/T2加权图像时，在其余4例患者中有3例检测到癌症，加上之前的19例患者（总体检测灵敏度为96%）。子宫内膜癌（n=22）的平均ADC值为（0.97±0.19）×10⁻³mm²/s，显著低于正常子宫内膜、子宫肌层、平滑肌瘤和子宫腺肌病（p<0.05）。
DW成像有助于在非增强磁共振成像中检测子宫子宫内膜癌。
