Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital & Institute, 52# Fucheng Road, Haidian District, Beijing 100142, China.
Eur J Radiol. 2012 Aug;81(8):1926-30. doi: 10.1016/j.ejrad.2011.04.019. Epub 2011 May 17.
To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma.
The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b=0 and b=1000s/mm(2)). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed.
ADC values were different in three zones of uterine body (P<0.001), with the lowest in junctional zone [(1.126±0.190)×10(-3)mm(2)/s] and highest in outer myometrium [(1.496±0.196)×10(-3)mm(2)/s]. Mean ADC value of endometrial carcinomas [(1.011±0.121)×10(-3)mm(2)/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P<0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased.
Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.
评估表观扩散系数（ADC）值与子宫内膜癌局部侵袭性的关系。
回顾性分析经术后病理证实的 73 例子宫内膜癌患者和 64 例健康子宫的磁共振成像（MRI）资料。所有 MRI 检查均包括轴位 T2WI 和 T1WI、矢状位 T2WI 和弥散加权序列（b=0 和 b=1000s/mm(2)）。在术后处理工作站上使用体素分析软件获取肿瘤大小、平均 ADC 值（ADCm）和四分位 ADC（ADCq）。采用方差分析比较正常子宫体三层和子宫内膜癌之间 ADC 值的差异。根据病理类型、组织学分级、肌层浸润深度、宫颈侵犯和脉管间隙侵犯、淋巴结转移情况对患者进行分组，比较肿瘤大小和 ADC 值。
子宫体三个区域的 ADC 值不同（P<0.001），交界区最低[（1.126±0.190）×10(-3)mm(2)/s]，外肌层最高[（1.496±0.196）×10(-3)mm(2)/s]。子宫内膜癌的平均 ADC 值[（1.011±0.121）×10(-3)mm(2)/s]低于正常子宫体。具有更多侵袭性病理因素的组中，ADC 值 quartile 和肿瘤大小越大（P<0.05）。随着 quartile ADC 值和肿瘤大小的增加，深层肌层浸润、宫颈侵犯、脉管间隙侵犯和淋巴结转移更为常见。
子宫内膜癌的平均 ADC 值低于正常子宫。代表水分子运动异质性的 quartile ADC 与子宫内膜癌的侵袭性密切相关，而平均 ADC 值则不然。ADC 值可能作为补充常规序列的定量指标。
