Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Magn Reson Imaging. 2013 May;37(5):1151-9. doi: 10.1002/jmri.23900. Epub 2012 Nov 13.
To prospectively assess the usefulness of diffusion-weighted magnetic resonance imaging (MRI) with background body signal suppression (DWIBS) at 3T for the preoperative evaluation of endometrial cancer.
Fifty-two consecutive patients with biopsy-proven endometrial cancer were examined with a 3T MR scanner, followed by a hysterectomy. MR examinations included T2-weighted (T2WI), DWIBS, and dynamic contrast-enhanced T1-weighted imaging (DCEI). The apparent diffusion coefficient (ADC) was calculated in the tumor and normal myometrium. According to tumor grade, the mean ADC of the tumor was analyzed. The depth of myometrial invasion was independently assessed by two radiologists for three MRI datasets on a five-point scale.
The mean ADC of the tumors was significantly lower than that of normal myometrium (P < 0.001). The mean ADC of grades 2 or 3 was significantly lower than grade 1 (P < 0.01). For predicting myometrial invasion, the specificity, accuracy, and area under the curve of combined T2WI and DWIBS in both readers were similar to DCEI (P > 0.05). Interreader agreement in all MRI datasets was excellent.
DWIBS at 3T has potential for being an effective method for the preoperative evaluation of endometrial cancer.
前瞻性评估背景抑制弥散加权磁共振成像（DWIBS）在 3T 场强下对子宫内膜癌术前评估的作用。
52 例经活检证实的子宫内膜癌患者在 3T 磁共振扫描仪上进行检查，随后进行子宫切除术。MR 检查包括 T2 加权成像（T2WI）、DWIBS 和动态对比增强 T1 加权成像（DCEI）。在肿瘤和正常子宫肌层中计算表观扩散系数（ADC）。根据肿瘤分级，分析肿瘤的平均 ADC。两名放射科医生对 3 组 MRI 数据集进行 5 分制评估，以独立评估子宫肌层浸润的深度。
肿瘤的平均 ADC 明显低于正常子宫肌层（P < 0.001）。2 级或 3 级的平均 ADC 明显低于 1 级（P < 0.01）。对于预测肌层浸润，两名读者的 T2WI 和 DWIBS 联合的特异性、准确性和曲线下面积与 DCEI 相似（P > 0.05）。所有 MRI 数据集的读者间一致性均为优秀。
3T 场强下的 DWIBS 可能是子宫内膜癌术前评估的一种有效方法。
