Hawighorst H, Bock M, Knopp M V, Essig M, Schoenberg S O, Knapstein P G, Schad L R, van Kaick G
Forschungsschwerpunkt, Radiologische Diagnostik und Therapie des Deutschen Krebsforschungszentrum (dkfz), Heidelberg.
Radiologe. 1998 Jun;38(6):539-44. doi: 10.1007/s001170050389.
The aim of this pilot study was to evaluate a 2D-STAR technique as a non contrast-enhanced approach to demonstrate the uterine artery and its branches and to assess the cervical uterine blood flow in healthy volunteers and in patients with advanced uterine cervical carcinoma.
Seven healthy volunteers (mean age, 29 years) and twenty-two patients (mean age, 52 years) with advanced cancer of the uterine cervix (FIGO IIB-IVA) were prospectively examined by 2D-STAR imaging at different inversion delay times (300 ms-1900 ms) which showed the passage of a blood bolus through normal and malignant tissue of the uterine cervix.
The uterine artery was well visualized with short inversion delay times of 300 ms to 500 ms. It was characterized as single or multiple helical loops before dividing into its intracervical branches. The intracervical branching was observed at inversion delay times of 500 ms-700 ms. With longer inversion delay times arterial signal enhancement disappeared and cervical tissue enhancement was noted. Enhancement of benign tissue was observed at inversion delay times of 1100 ms-1700 ms, and in malignant tissue at shorter inversion delay times of 900 ms-1300 ms. The maximum of this diffuse signal enhancement of benign tissue was seen at inversion delay times of 1500 ms (1100 ms-1700 ms), in malignant tissue at significantly (P < 0.05) shorter inversion delay times of 1100 ms (900 ms to 1300).
Our preliminary results show that the vascular supply and blood flow of the normal uterine cervix and of advanced cervical cancer can be assessed by non contrast-enhanced 2D STAR imaging and that malignant cervical tissue is earlier and stronger perfused than normal cervical tissue.
本初步研究的目的是评估二维星状（2D-STAR）技术作为一种非增强对比的方法，用于显示子宫动脉及其分支，并评估健康志愿者和晚期子宫颈癌患者的子宫颈血流情况。
对7名健康志愿者（平均年龄29岁）和22名晚期子宫颈癌患者（平均年龄52岁，国际妇产科联盟（FIGO）分期为IIB-IVA期）进行前瞻性研究，采用二维星状成像在不同反转延迟时间（300毫秒至1900毫秒）下进行检查，该成像显示了血流团块通过子宫颈正常组织和恶性组织的情况。
在300毫秒至500毫秒的短反转延迟时间下，子宫动脉显示良好。其特征为在分成子宫颈内部分支之前呈单螺旋或多螺旋环。在500毫秒至700毫秒的反转延迟时间下观察到子宫颈内分支。随着反转延迟时间延长，动脉信号增强消失，同时观察到子宫颈组织增强。在1100毫秒至1700毫秒的反转延迟时间下观察到良性组织增强，在900毫秒至1300毫秒的较短反转延迟时间下观察到恶性组织增强。良性组织这种弥漫性信号增强的最大值出现在1500毫秒（1100毫秒至1700毫秒）的反转延迟时间，而恶性组织的最大值出现在明显较短的1100毫秒（900毫秒至1300毫秒）反转延迟时间（P<0.05）。
我们的初步结果表明，通过非增强对比的二维星状成像可以评估正常子宫颈和晚期子宫颈癌的血管供应和血流情况，并且恶性子宫颈组织比正常子宫颈组织灌注更早且更强。
