Yoshimoto Chiharu, Takahama Junko, Iwabuchi Takuya, Uchikoshi Masato, Shigetomi Hiroshi, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University.
Magn Reson Med Sci. 2017 Apr 10;16(2):137-145. doi: 10.2463/mrms.mp.2016-0028. Epub 2016 Sep 16.
Heme and iron accumulation due to repeated hemorrhage in endometriosis may contribute to a pivotal role in carcinogenesis. We evaluate the clinical application of MR relaxometry in a series of ovarian endometriosis (OE) and endometriosis-associated ovarian cancer (EAOC).
A prospective study of diagnostic accuracy was conducted among 82 patients (67 OE and 15 EAOC) to compare MR relaxometry and biochemical measurement of cyst fluid total iron concentration. Transverse relaxation rate R2 value was determined using a single-voxel, multi-echo MR sequence (HISTO) by a 3T-MR system. Phantom experiments were also performed to assess the correlation between the ex vivo R2 values and total iron concentrations.
Both the results of phantom experiments and in vivo human data confirmed that in vivo R2 values were highly correlated with total iron concentrations. Compared to OE, EAOC exhibit decreased in vivo R2 values and total iron levels, regardless of their age, menopausal status and cyst size. The use of in vivo R2 values retained excellent accuracy in distinguishing EAOC versus OE (sensitivity and specificity: 86% and 94%).
We have demonstrated that MR relaxometry provides a noninvasive predictive tool to discriminate between EAOC and OE.
子宫内膜异位症中反复出血导致的血红素和铁蓄积可能在致癌过程中起关键作用。我们评估了磁共振弛豫测量法在一系列卵巢子宫内膜异位症（OE）和子宫内膜异位症相关卵巢癌（EAOC）中的临床应用。
对82例患者（67例OE和15例EAOC）进行了一项关于诊断准确性的前瞻性研究，以比较磁共振弛豫测量法和囊液总铁浓度的生化测量。使用3T磁共振系统通过单像素多回波磁共振序列（HISTO）测定横向弛豫率R2值。还进行了体模实验以评估体外R2值与总铁浓度之间的相关性。
体模实验结果和体内人体数据均证实，体内R2值与总铁浓度高度相关。与OE相比，EAOC的体内R2值和总铁水平降低，无论其年龄、绝经状态和囊肿大小如何。使用体内R2值在区分EAOC与OE方面保持了出色的准确性（敏感性和特异性：86%和94%）。
我们已经证明磁共振弛豫测量法提供了一种非侵入性的预测工具，可用于区分EAOC和OE。
