Department of Diagnostic Radiology, HS Gerardo, Monza, Milan, Italy.
AJR Am J Roentgenol. 2011 Jul;197(1):256-62. doi: 10.2214/AJR.10.5584.
The objective of our study was to investigate whether apparent diffusion coefficient (ADC) values of endometrial cancer differ from those of normal endometrium and myometrium and whether they vary according to histologic tumor grade, the depth of myometrial invasion, or lymph node status.
Seventy patients with histologically proved endometrial cancer and 36 control subjects with normal endometrium were enrolled in this prospective study. T2-weighted, dynamic T1-weighted, and diffusion-weighted images with b values of 0 and 1000 s/mm(2) were obtained of all patients. The ADC values of endometrial cancer, normal endometrium, and normal myometrium were recorded. Tumor grade, the depth of myometrial invasion, and lymph node status were assessed at postoperative histopathologic analysis.
The mean (± SD) ADC value (10(-3) mm(2)/s) of endometrial cancer (0.77 ± 0.12) was significantly lower than that of normal endometrium (1.31 ± 0.11, p < 0.0001) and normal myometrium (1.52 ± 0.21, p < 0.0001), with no overlap between the two former distributions. There was no significant difference between ADC values of endometrial cancer tissue in patients with tumor grade 1 (0.79 ± 0.08, n = 14), grade 2 (0.76 ± 0.14, n = 40), or grade 3 (0.75 ± 0.12, n = 16) (p = 0.67); in patients with deep (0.77 ± 0.13, n = 18) and those with superficial (0.76 ± 0.12, n = 52) myometrial invasion (p = 0.87); and in patients with (0.78 ± 0.10, n = 6) and those without (0.75 ± 0.14, n = 39) lymph node metastases (p = 0.64).
ADC values allow normal endometrium to be differentiated from endometrial carcinoma; however, they do not correlate with histologic tumor grade, the depth of myometrial invasion, or whether lymph node metastases are present.
本研究旨在探讨子宫内膜癌的表观扩散系数（ADC）值是否与正常子宫内膜和子宫肌层不同，以及它们是否随组织学肿瘤分级、肌层浸润深度或淋巴结状态而变化。
本前瞻性研究纳入了 70 例经组织学证实的子宫内膜癌患者和 36 例正常子宫内膜对照者。所有患者均接受 T2 加权、动态 T1 加权和扩散加权成像，b 值为 0 和 1000 s/mm²。记录子宫内膜癌、正常子宫内膜和正常子宫肌层的 ADC 值。术后病理分析评估肿瘤分级、肌层浸润深度和淋巴结状态。
子宫内膜癌的平均（± SD）ADC 值（10⁻³mm²/s）为 0.77 ± 0.12，明显低于正常子宫内膜（1.31 ± 0.11，p < 0.0001）和正常子宫肌层（1.52 ± 0.21，p < 0.0001），且前两者分布无重叠。肿瘤分级为 1 级（0.79 ± 0.08，n = 14）、2 级（0.76 ± 0.14，n = 40）或 3 级（0.75 ± 0.12，n = 16）的患者之间，或肌层浸润深度为深肌层（0.77 ± 0.13，n = 18）或浅肌层（0.76 ± 0.12，n = 52）的患者之间，或有淋巴结转移（0.78 ± 0.10，n = 6）或无淋巴结转移（0.75 ± 0.14，n = 39）的患者之间，ADC 值均无显著差异（p = 0.67；p = 0.87；p = 0.64）。
ADC 值可区分正常子宫内膜与子宫内膜癌；但与组织学肿瘤分级、肌层浸润深度或淋巴结转移情况无关。
