摘要
目的:探讨体素内不相干运动扩散加权成像(IVIM-DWI)定量测量正常子宫微循环灌注随月经周期变化的价值。方法:10例育龄期健康女性志愿者于经期(第3天)、增生早期(第7天)、增生晚期(第12天)、分泌早期(第17天)及经前期(第27天)行盆腔MRI扫描。扫描序列包括T1WI、T2WI和IVIM。测量子宫内膜、结合带及外肌层的真实扩散系数(D)、假性扩散系数(D*)和灌注分数(f)。比较月经周期各时间点D、D*及f值的差异,统计方法采用随机区组设计方差分析。结果:不同时间点间两两比较,子宫的三层结构中仅内膜的f值在经前期与增生早期以及结合带的f值在经前期与经期、经前期与增生早期间的差异具有统计学意义(P值分别为0.015、0.037、0.038),其余各时间点间f、D和D*值的差异无统计学意义(P>0.05);内膜的f值自增生早期至经前期呈现先上升后下降的变化趋势,且在增生晚期达峰值。子宫3层结构间两两比较,在经期、增生早期、分泌早期和经前期,内膜与结合带、结合带与外肌层间D值的差异具有统计学意义(P值分别为0.048、0.024、0.009和0.014;0.029、0.001、0.004和0.000),且D值的大小为结合带<内膜<外肌层;除经期外,其它4期时子宫内膜与外肌层、结合带与外肌层间f值的差异均有统计学意义(P<0.05);除经期和增生晚期,其它3期时子宫内膜与外肌层、结合带与外肌层间D*值的差异亦具有统计学意义(P<0.05)。结论:IVIM-DWI是非侵入性评价正常子宫在月经周期中微循环变化情况的有效方法。
Objective： To investigate the value of intravoxel incoherent motion diffusion weighted imaging （IVIM- DWI） for quantifying microvaseulation changes of normal uterus during menstrual cycle. Methods：Ten healthy female volunteers of reproductive age underwent pelvic MRI examination including T1WI,T2WI, and IVIM-DWI at five periods of menstrual cycle including menstruation, early hyperplasia phase,late hyperplasia phase, early secretion phase, and pre-men struation phases. Diffusion coefficient （D）, pseudodiffusion coefficient （D＊）, and perfusion fraction （f） of endometrium, junctional zone and myometrium of uterus were measured and compared. Analysis of variance for randomized block design was used for statistical analysis. Results：For each of the three layers of uterine wall, the f,D and D＊ at different phases were compared using pairwise comparison among groups, significant difference was only found in f value between menstruation and early hyperplasia phase for endometrium,and between pre- menstruation and menstruation,early hyperplasia phase and pre-menstruation for junctional zone （P = 0. 015,0. 037 and 0. 038, respectively）. From early hyperplasia phase to pre-men- strual phase,the f value of endometrium increased firstly, reached the peak value in the late of hyperplasia phase and then decreased. In each phase of menstrual cycle, the three indexes were compared using pairwise comparison among the three layers of uterus： except late hyperplasia phase,in the other four phases there was significant difference in D value of junctional zone compared with endometrium or myometrium （P= 0. 048,0. 024,0. 009 and 0. 014;and 0. 029,0. 001,0. 004 and 0. 000;respectively）,and the mean of D value was junctional zone 〈 endometrium 〈myometrium; except menstruation, in the other four phases there was significant difference on f value of junctional zone compared with endometrium or myometrium （P〈0.05）; for D＊ value, in early hyperplasia phase, early secretion phase, and pre-menstruation, there was significant difference between endometrium with junctional zone, and junctional zone with myometrium （P〈0.05）. Conclusion： IVIM DWI may be a noninvasive method for evaluation of uterine microcirculation during menstrual cycle.
出处
《放射学实践》
北大核心
2016年第12期1213-1218,共6页
Radiologic Practice
基金
国家自然科学基金(81471628)
上海市科委医学引导项目(124119a3300)
上海市卫生系统先进适宜技术推广项目(2013SY075)
关键词
子宫
微循环
月经周期
体素内不相干运动
磁共振成像
Uterus
Microcirculation
Menstrual cycle
Intravoxel incoherent motion
Magnetic resonance imaging
作者简介
陈天佑（1989-），男，河南永城人，住院医师、硕士，主要从事体部影像诊断工作。通讯作者：强金伟，Email：dr．jinweiqiang@163．com
