University Department of Radiology, Box 218, Level 5, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom.
Eur J Radiol. 2010 Dec;76(3):367-85. doi: 10.1016/j.ejrad.2010.01.026.
Functional imaging by means of dynamic multiphase contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted magnetic resonance imaging (DW-MRI) is now part of the standard imaging protocols for evaluation of the female pelvis. DCE-MRI and DW-MRI are important MR imaging techniques which enable the radiologist to move from morphological to functional assessment of diseases of the female pelvis. This is mainly due to the limitations of morphologic imaging, particularly in lesion characterization, accurate lymph node staging, assessment of tumour response and inability to differentiate post-treatment changes from tumour recurrence. DCE-MRI improves the accuracy of T2WI in staging of endometrial cancer. It also helps differentiate tumour recurrence from radiation fibrosis in patients with cervical cancer. DCE-MRI improves characterization of cystic adnexal lesions and detection of small peritoneal implants in patients with ovarian cancer. DW-MRI is valuable in preoperative staging of patients with endometrial and cervical cancer, especially in detection of extra-uterine disease. It does increase reader's confidence for detection of recurrent disease in gynaecological malignancies and improves detection of small peritoneal implants in patients with ovarian cancer. In this review article we give an overview of both DCE-MRI and DW-MRI techniques, concentrating on their main clinical application in the female pelvis, and present a practical approach of the added value of these techniques according to the main pathological conditions, highlighting the pearls and pitfalls of each technique.
功能成像采用动态多期对比增强磁共振成像（DCE-MRI）和弥散加权磁共振成像（DW-MRI），现在是女性盆腔评估的标准成像方案的一部分。DCE-MRI 和 DW-MRI 是重要的磁共振成像技术，使放射科医生能够从形态学评估转向女性盆腔疾病的功能评估。这主要是由于形态学成像的局限性，特别是在病变特征、准确的淋巴结分期、肿瘤反应评估以及无法区分治疗后变化与肿瘤复发方面。DCE-MRI 提高了 T2WI 分期子宫内膜癌的准确性。它还有助于区分宫颈癌患者的肿瘤复发与放射纤维化。DCE-MRI 改善了囊性附件病变的特征，并检测了卵巢癌患者的小腹膜种植。DW-MRI 对子宫内膜癌和宫颈癌患者的术前分期有价值，特别是在检测子宫外疾病方面。它确实增加了读者对妇科恶性肿瘤中复发病灶的检测信心，并提高了卵巢癌患者小腹膜种植的检测能力。在这篇综述文章中，我们概述了 DCE-MRI 和 DW-MRI 技术，重点介绍了它们在女性盆腔中的主要临床应用，并根据主要病理情况提出了这些技术的附加价值的实用方法，突出了每种技术的要点和难点。
