Yamada Ichiro, Sakamoto Junichiro, Kobayashi Daisuke, Miyasaka Naoyuki, Wakana Kimio, Oshima Noriko, Wakabayashi Akira, Saida Yukihisa, Tateishi Ukihide, Eishi Yoshinobu
Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan.
Magn Reson Imaging. 2019 Apr;57:337-346. doi: 10.1016/j.mri.2018.12.009. Epub 2018 Dec 30.
In this study, we aimed to determine the usefulness of diffusion kurtosis imaging (DKI) as a noninvasive method for the evaluation of tumor invasion depth, histological grade, and lymph node metastasis in patients with endometrial carcinoma (EMC).
Our institutional review board approved this retrospective study and waived informed consent. In total, 24 patients suspected of having EMC were examined by a 1.5-T magnetic resonance imaging. DKI data were obtained using a single-shot echo-planar imaging sequence with four b values (0, 500, 1000, and 2000 s/mm). Kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) maps were generated and compared with histopathological findings.
K maps from all patients identified the junctional zone as a distinct high-K zone (1.443 ± 0.362). This zone was significantly different from the zone of endometrium and outer myometrium (0.678 ± 0.179 and 0.694 ± 0.113, respectively; P < 0.001). K and D values of all EMCs were significantly different from those of all normal uterine wall layers. K and D values were significantly correlated with histological grades of endometrioid adenocarcinomas (r = 0.799, P < 0.001 and r = -0.799, P < 0.001, respectively), while ADC values were not (r = -0.243, P = 0.382). Metastatic and nonmetastatic lymph nodes showed significantly different K (P = 0.001) and D (P = 0.001) values, but not ADC values (P = 0.827).
DKI may be clinically useful for the noninvasive evaluation of depth of tumor invasion, histological grade, and lymph node metastasis in patients with EMC.
在本研究中，我们旨在确定扩散峰度成像（DKI）作为一种非侵入性方法，用于评估子宫内膜癌（EMC）患者的肿瘤浸润深度、组织学分级和淋巴结转移的实用性。
我们机构的审查委员会批准了这项回顾性研究，并豁免了知情同意。共有24例疑似患有EMC的患者接受了1.5-T磁共振成像检查。使用具有四个b值（0、500、1000和2000 s/mm）的单次激发回波平面成像序列获取DKI数据。生成峰度（K）、扩散率（D）和表观扩散系数（ADC）图，并与组织病理学结果进行比较。
所有患者的K图均将结合带识别为明显的高K区（1.443±0.362）。该区域与子宫内膜和外层肌层区域有显著差异（分别为0.678±0.179和0.694±0.113；P<0.001）。所有EMC的K和D值与所有正常子宫壁层的K和D值有显著差异。K和D值与子宫内膜样腺癌的组织学分级显著相关（分别为r = 0.799，P<0.001和r = -0.799，P<0.001），而ADC值则无相关性（r = -0.243，P = 0.382）。转移性和非转移性淋巴结的K值（P = 0.（此处原文似乎有误，应为0.001））和D值（P = 0.001）有显著差异，但ADC值无差异（P = 0.827）。
DKI在临床上可能有助于对EMC患者进行肿瘤浸润深度、组织学分级和淋巴结转移 的非侵入性评估。
