T2加权磁共振成像上子宫肌层高信号肿块：与扩散加权磁共振成像的鉴别诊断
Hyperintense uterine myometrial masses on T2-weighted magnetic resonance imaging: differentiation with diffusion-weighted magnetic resonance imaging.
作者信息
Takeuchi Mayumi, Matsuzaki Kenji, Nishitani Hiromu
机构信息
Department of Radiology, University of Tokushima, Kuramoto-cho, Tokushima, Japan.
出版信息
J Comput Assist Tomogr. 2009 Nov-Dec;33(6):834-7. doi: 10.1097/RCT.0b013e318197ec6f.
OBJECTIVE
The objective was to determine whether diffusion-weighted imaging (DWI) might be useful in differentiating uterine leiomyomas exhibiting hyperintensity on T2-weighted images from malignant lesions.
METHODS
Thirty-four uterine myometrial lesions including 7 malignant tumors and 27 leiomyomas (6 cellular leiomyomas [CLM] and 21 degenerated leiomyomas [DLM]) were evaluated. The apparent diffusion coefficients (ADC) in cellular portions of the lesions were measured (10(-3) mm2/s).
RESULTS
All malignant tumors showed high signal intensity on DWI with low ADC (mean [SD], 0.79 [0.26]), which was significantly lower (P < 0.01) than that in benign leiomyomas (1.51 [0.33]). The ADC in CLM (1.18 [0.16]) was significantly lower (P < 0.01) than that in DLM (1.60 [0.30]) and higher (P < 0.05) than that in malignant tumors.
CONCLUSIONS
It was difficult to differentiate malignant tumors from leiomyomas on the basis of signal intensity on DWI; however, the ADC measurement may be helpful to distinguish malignant tumors, CLM, and DLM.
目的
确定扩散加权成像（DWI）是否有助于鉴别在T2加权图像上表现为高信号的子宫平滑肌瘤与恶性病变。
方法
评估了34个子宫肌层病变，包括7个恶性肿瘤和27个平滑肌瘤（6个富于细胞平滑肌瘤[CLM]和21个退变平滑肌瘤[DLM]）。测量病变细胞部分的表观扩散系数（ADC）（10⁻³mm²/s）。
结果
所有恶性肿瘤在DWI上均表现为高信号，ADC值低（均值[标准差]，0.79[0.26]），显著低于良性平滑肌瘤（1.51[0.33]）（P<0.01）。CLM的ADC值（1.18[0.16]）显著低于DLM（1.60[0.30]），且高于恶性肿瘤（P<0.05）。
结论
基于DWI上的信号强度难以区分恶性肿瘤与平滑肌瘤；然而，ADC测量可能有助于鉴别恶性肿瘤、CLM和DLM。
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