Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness
Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness
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DOI：
10.1016/j.ejrad.2011.04.019
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发表时间：
2012-08-01
影响因子：
3.3
通讯作者：
Zhang, Xiao-Peng
中科院分区：
文献类型：
--
作者：
Cao, Kun;Gao, Min;Zhang, Xiao-Peng
目的：为探讨表观扩散系数（apparent diffusion coefficient，ADC）值与子宫内膜癌局部浸润性的关系，方法：回顾性分析73例经手术病理证实的子宫内膜癌患者和64例正常子宫的MRI表现。所有患者均行轴位T2 WI、T1 WI、矢状位T2 WI及弥散加权序列（B = 0和B = 1000 s/mm（2））。在后处理工作站上使用体素分析软件获得肿瘤大小、平均ADC值（ADCm）和四分位ADC值（ADCq）。采用方差分析比较正常子宫体及子宫内膜癌各层间ADC值的差异。根据病理类型、组织学分级、肌层浸润深度、宫颈浸润、淋巴管浸润和淋巴结转移情况分组。结果：子宫体不同区域ADC值不同（P < 0.001），交界区ADC值最低[（1.126 ± 0.190）× 10 - 3 mm（2）/s]，外肌层ADC值最高[（1.496 ± 0.196）× 10 - 3 mm（2）/s]。子宫内膜癌的平均ADC值[（1.011 ± 0.121）× 10（-3）mm（2）/s]低于正常子宫体。浸润性病理因素多的组ADC值和肿瘤大小明显大于浸润性病理因素多的组（P < 0.05）。结论：子宫内膜癌的平均ADC值低于正常子宫，且随着ADC值的增大，肿瘤体积增大，肌层浸润、宫颈浸润、淋巴管间隙浸润和淋巴结转移的发生率增高。四分位ADC值代表了肿瘤内水运动的异质性，与子宫内膜癌的侵袭性有着深刻的关系，而平均ADC值则没有。ADC值可作为定量指标补充常规序列。(c)2011爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma.Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000s/mm(2)). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed.Results: ADC values were different in three zones of uterine body (P < 0.001), with the lowest in junctional zone [(1.126 +/- 0.190) x 10(-3) mm(2)/s] and highest in outer myometrium [(1.496 +/- 0.196) x 10(-3) mm(2)/s]. Mean ADC value of endometrial carcinomas [(1.011 +/- 0.121) x10(-3) mm(2)/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased.Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences. (c) 2011 Elsevier Ireland Ltd. All rights reserved.