摘要
目的探讨子宫肌瘤3.0T MRI的IVIM-DWI参数值与其供血程度和细胞密集度的相关性。方法对22例经临床确诊的子宫肌瘤患者(共29个病灶)在HIFU刀治疗之前进行常规MRI平扫及增强,以及IVIM-DWI功能成像,扫描结束后在GE AW4.5工作站分别测量病灶与正常肌层的stand ADC,Slow ADC,Fast ADC,f值,结合病灶在T_2WI序列的信号强度及其强化程度,以获得的各相关参数的均数作为子宫肌瘤的IVIM参数值,对所得结果进行统计学分析。结果29个子宫肌瘤在T_2WI压脂序列上的信号强度分别为等信号(16/29),高信号(8/29),低信号(5/29);强化程度分别为高度强化(10/29),中度强化(9/29),轻度强化(10/29);Stand ADC,Slow ADC,fast ADC,f值分别是(0.85±0.20)×10^(-3)mm^2/s、(0.72±0.43)×10^(-3)mm^2/s、(16.47±10.51)×10^(-3)mm^2/s、0.44±0.20。正常子宫肌层的Stand ADC,Slow ADC,fast ADC,f值分别是(1.06±0.10)×10^(-3)mm^2/s、(1.16±0.15)×10^(-3)mm^2/s、(68.69±51.92)×10^(-3)mm^2/s、0.32±0.094。子宫肌瘤及正常子宫肌层的Stand ADC,Slow ADC,fast AD,f值的差异均具有统计学意义(P<0.05);子宫肌瘤的fast ADC值与强化程度呈正相关(r值为0.505,P值为0.001),f值与肌瘤的强化程度呈负相关(r值为-0.454,P值为0.013)。结论 IVIM-DWI序列的Slow ADC值较Stand ADC值能更好地反映子宫肌瘤细胞的密集度;IVIM-DWI的序列fast ADC值与f值有助于在不增强时帮助识别富血供性子宫肌瘤。
Objective To investigate the correlation between the parametric values of intravoxel incoherent motion diffusionweighted imaging（ IVIM-DWI） and blood level and cellular density in uterine fibroids with 3. 0 T magnetic resonance imaging（ MRI）. Methods Twenty two patients with twenty nine uterine fibroids,who are diagnosed clinically,are scanned with MRI nonenhanced,enhanced and IVIM-DWI sequences before the treatment of High intensity focused ultrasound（ HIFU）,Stand ADC,Slow ADC,fast ADC and f values of fibroids and normal muscle wre respectively measured on AW4. 5 workstation after scanning. The means of relative parameters which obtained are served the parametric values of uterine fibroids combine the signal intensity and enhanced degree of fibroids in T2 weight imaging,all results are statistically analyzed. Results The signal performance of all fibroids on the T2WI repressive sequence was high signal（ 8/29）,intermediate signal（ 16/29）,and low signal（ 5/29）; Enhanced degree was high enhancement（ 10/29）,moderate enhancement（ 9/29）,and mild enhancement（ 10/29）. Stand ADC,Slow ADC,fast ADC and f values of uterine fibroids were（ 0. 85 ± 0. 20） × 10^-3mm^2/s,（ 0. 72 ± 0. 43） × 10^-3mm^2/s,（ 16. 47 ± 10. 51） × 10^-3mm^2/s,0. 44 ± 0. 20. Stand ADC,Slow ADC,fast ADC and f values of Normal muscle were（ 1. 06 ±0. 10） × 10^-3mm^2/s,（ 1. 16 ± 0. 15） × 10^-3mm^2/s,（ 68. 69 ± 51. 92） × 10^-3mm^2/s,0. 32 ± 0. 094. The difference of Stand ADC,Slow ADC,fast ADC and f values in uterine fibroids and normal uterine muscle were statistically significant（ P〈0. 05）.fast ADC and f values of uterine fibroids and the enhanced degree of the fibroids were positive,negative correlation（ r values were0. 505,-0. 454）. Conclusion The Slow ADC value of IVIM-DWI sequence can reflect cellular density of uterine fibroids than Stand ADC value; The fast ADC and f values of it contribute to identify the rich blood supply of uterine fibroids without enhancement.
出处
《医学影像学杂志》
2017年第10期1962-1966,共5页
Journal of Medical Imaging
关键词
子宫肌瘤
磁共振成像
体素内不相干运动
扩散加权成像
Uterine fibroids
Magnetic resonance imaging
Intravoxel incoherent motion
Diffusion weighted imaging
作者简介
张利祥（1989-），男，河南新乡人，毕业于新乡医学院，在读研究生，主要从事医学影像学诊断工作
通信作者：董江宁教授，硕士生导师，主任医师E—mail：dongjn@163．com
