CAJ | 학술논문

目的：研究子宫肌瘤患者子宫正常区域各分区结构(内膜、结合带、肌层)表观弥散系数(ADC)特点及其随月经周期的变化趋势。方法31例具有正常月经周期的子宫肌瘤患者，分为分泌期(17例)和增殖期(14例)两组。行子宫横断面DWI(b值为0、700s/mm2)扫描，分别测量子宫内膜、结合带和肌层ADC值，分析子宫分区结构ADC值差异及月经周期对其影响。结果分泌期组，子宫三层分区结构ADC值两两之间有明显统计学差异(F=104.279，p＜0.001)。增殖期组，内膜和肌层ADC值之间无统计学差别；结合带ADC值均小于内膜、肌层ADC值，有明显统计学差异(P＜0.001)。肌层ADC值在分泌期组(1.726±0.210×10-3mm2/s)和增殖期组(1.550±0.128×10-3mm2/s)有统计学差异(t=2.729，p＜0.05)；内膜在分泌期组和增殖期组比较，以及结合带在分泌期组和增殖期组比较，均无统计学差异。结论具有正常月经周期的子宫肌瘤患者子宫体部正常区域ADC值受到解剖分区结构及月经周期的影响。同时，内膜及结合带ADC值在增殖期和分泌期无统计学差异，可能与子宫肌瘤患者性激素分泌异常相关。
목적：연구자궁기류환자자궁정상구역각분구결구(내막、결합대、기층)표관미산계수(ADC)특점급기수월경주기적변화추세。방법31례구유정상월경주기적자궁기류환자，분위분비기(17례)화증식기(14례)량조。행자궁횡단면DWI(b치위0、700s/mm2)소묘，분별측양자궁내막、결합대화기층ADC치，분석자궁분구결구ADC치차이급월경주기대기영향。결과분비기조，자궁삼층분구결구ADC치량량지간유명현통계학차이(F=104.279，p＜0.001)。증식기조，내막화기층ADC치지간무통계학차별；결합대ADC치균소우내막、기층ADC치，유명현통계학차이(P＜0.001)。기층ADC치재분비기조(1.726±0.210×10-3mm2/s)화증식기조(1.550±0.128×10-3mm2/s)유통계학차이(t=2.729，p＜0.05)；내막재분비기조화증식기조비교，이급결합대재분비기조화증식기조비교，균무통계학차이。결론구유정상월경주기적자궁기류환자자궁체부정상구역ADC치수도해부분구결구급월경주기적영향。동시，내막급결합대ADC치재증식기화분비기무통계학차이，가능여자궁기류환자성격소분비이상상관。
Objective To investigate the characteristics and changes of apparent diffusion coefficient (ADC) value of the normal uterine zonal structures (epithelium, junctional zone, and myometrium) of fibroid patients during the menstrual cycle. Methods The study included 31 fibroid patients in reproductive age and each with regular cycle, divided into secretory phase group (17 cases) and proliferative phase group (14 cases). Diffusion weighted imaging (DWI) was performed along the axial plane, using b value of 0 and 700s/mm2. The uterine ADC values of different zonal structures in different phases of the menstrual cycle were compared by statistic analysis with ANOVA, LSD, and t test. Results The ADC values among each uterine zonal structures were significantly different from another in secretory phase group (F=104.279,p<0.001); whereas in proliferative phase group, the ADC valuse between epithelium and myometrium were no significantly different, and there were significant difference in ADC values between junctional zone and other two zones(p<0.001). The ADC values of myometrium were significantly different(t=2.729,p<0.05) between secretory phase group(1.726±0.210×10-3mm2/s) and proliferative phase group(1.550±0.128×10-3mm2/s). Conclusion An obvious ADC values variation in normal area of uterus in fibroid patients because of the deferences influence from uterus zonal structures and menstrual cycle. No significace differences between the epithelium and junction zone in secretory and proliferation phase may be in result of inappropriate antidiuretic hormone in fibroid patients.