评价磁共振弥散加权成像在鉴别累及肠的子宫内膜异位症与结直肠癌中的作用。

Evaluation of MR diffusion-weighted imaging in differentiating endometriosis infiltrating the bowel from colorectal carcinoma.

机构信息

VU University Medical Center, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands.

出版信息

Eur J Radiol. 2012 Jun;81(6):1376-80. doi: 10.1016/j.ejrad.2011.03.038. Epub 2011 Apr 13.

DOI:10.1016/j.ejrad.2011.03.038

PMID:21493029

Abstract

OBJECTIVE

Endometriosis infiltrating the bowel may be difficult to differentiate from colorectal carcinoma in cases that present with non-specific clinical and imaging features. The aim of this study is to assess the value of MR diffusion-weighted imaging (DWI) in differentiating endometriosis infiltrating the bowel from colorectal carcinoma.

METHODS

In 66 patients, MR DWI was added to the standard imaging protocol in patients visiting our outdoor MR clinic for the analysis of suspected or known deep infiltrating endometriosis (DIE). In patients diagnosed with DIE infiltrating the bowel on MR imaging, high b-value diffusion-weighted images were qualitatively assessed by two readers in consensus and compared to high b-value diffusion weighted images in 15 patients evaluated for colorectal carcinoma. In addition, ADC values of lesions were calculated, using b-values of 50, 400 and 800 s/mm(2).

RESULTS

A total of 15 patients were diagnosed with DIE infiltrating the bowel on MR imaging. Endometriosis infiltrating the bowel showed low signal intensity on high b-value diffusion-weighted images in all patients, whereas colorectal carcinoma showed high signal intensity on high b-value diffusion-weighted images in all patients. Mean ADC value in endometriosis infiltrating the bowel (0.80 ± 0.06 × 10(-3)mm(2)/s) was significantly lower compared to mean ADC value in colorectal carcinoma (0.86 ± 0.06 × 10(-3 )mm(2)/s), but with considerable overlap between ADC values.

CONCLUSION

Only qualitative assessment of MR DWI may be valuable to facilitate differentiation between endometriosis infiltrating the bowel and colorectal carcinoma.

摘要

目的

在具有非特异性临床和影像学特征的病例中，肠内子宫内膜异位症可能难以与结直肠癌区分。本研究旨在评估磁共振扩散加权成像（DWI）在区分肠内子宫内膜异位症和结直肠癌中的价值。

方法

在 66 名患者中，在我们的户外磁共振诊所就诊的疑似或已知深部浸润性子宫内膜异位症（DIE）患者中，在标准成像方案中添加了 MR DWI。在磁共振成像诊断为肠内子宫内膜异位症浸润的患者中，由两位读者通过共识对高 b 值弥散加权图像进行定性评估，并与 15 名接受结直肠癌评估的患者的高 b 值弥散加权图像进行比较。此外，使用 50、400 和 800 s/mm(2) 的 b 值计算病变的 ADC 值。

结果

总共 15 名患者在磁共振成像上诊断为肠内子宫内膜异位症浸润。在所有患者中，肠内子宫内膜异位症在高 b 值弥散加权图像上显示低信号强度，而在所有患者中，结直肠癌在高 b 值弥散加权图像上显示高信号强度。肠内子宫内膜异位症的平均 ADC 值（0.80±0.06×10(-3)mm(2)/s）明显低于结直肠癌的平均 ADC 值（0.86±0.06×10(-3)mm(2)/s），但 ADC 值之间有相当大的重叠。