Takeuchi M, Matsuzaki K, Nishitani H
Department of Radiology, University of Tokushima, Tokushima, Japan.
Acta Radiol. 2009 Oct;50(8):947-53. doi: 10.1080/02841850903099981.
Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis.
To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer.
Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer.
The ADC values (x10(-3) mm(2)/s) in cancer and benign lesions were 0.84+/-0.19 and 1.58+/-0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly.
DWI provides helpful information in evaluating benign and malignant endometrial lesions.
子宫内膜癌是最常见的妇科恶性肿瘤，良性子宫内膜增生或息肉应与子宫内膜癌相鉴别。在磁共振成像（MRI）评估子宫内膜癌时，评估肌层浸润深度很重要，因为它与患者预后密切相关。
验证扩散加权磁共振成像（DWI）区分良性和恶性子宫内膜病变以及评估子宫内膜癌肌层浸润的可行性。
对67例子宫内膜病变进行DWI检查并测量表观扩散系数（ADC），其中包括45例癌症和22例良性病变（增生和息肉）。对33例子宫内膜癌患者评估DWI和钆增强T1加权图像在评估肌层浸润方面的分期准确性。
癌症和良性病变的ADC值（×10⁻³mm²/s）分别为0.84±0.19和1.58±0.36（P<0.01）。DWI评估肌层浸润（浅或深）的分期准确性为94%，钆增强T1加权图像为88%。共存的子宫腺肌病和浸润性肌层浸润在钆增强T1加权图像上导致分期错误，而DWI能够正确显示肿瘤范围。
DWI在评估良性和恶性子宫内膜病变方面提供了有用信息。
