CAJ | 학술논문

目的对比分析Ⅰ期子宫内膜癌与子宫内膜息肉MR动态增强扫描的强化特征及临床价值.方法回顾性分析2012年4月至2014年6月温州医科大学附属第二医院经手术病理证实的14例Ⅰ期子宫内膜癌和13例子宫内膜息肉的MRI动态增强特征,对比分析不同组间病灶的时间-信号曲线(TIC)类型、各时段(16、32、48、64、109、154、199 s)的信号强度差值、早期相对信号强化率(ARSIR)、最大相对信号强化率(MRSIR)、总体相对信号强化率(SER)和强化峰值时间(TTP).结果 14例Ⅰ期内膜癌TIC曲线中,Ⅰ型4例,Ⅱ型6例,Ⅳ型4例;13例内膜息肉中,Ⅲ型3例,Ⅳ型10例.Ⅰ期内膜癌各期信号强度差值低于正常肌层,其中32、48、64、109、154、199 s的差异均有统计学意义(均P ＜0.05).Ⅰ期内膜癌MRSIR、TTP低于正常肌层;SER高于正常肌层,差异有统计学意义(P＜0.01).Ⅰ期内膜癌各期信号强度差值低于内膜息肉,其中32、48、64、109、154、199 s的差异均有统计学意义(均P ＜0.05).Ⅰ期内膜癌MRSIR、TTP低于内膜息肉;SER高于内膜息肉,差异均有统计学意义(P＜0.01).结论 3.0TMR动态增强检查能定量分析Ⅰ期子宫内膜癌及内膜息肉在各阶段的强化特点,其定量数据及TIC曲线类型对二者的诊断及鉴别诊断具有较大价值.
목적 대비분석Ⅰ기자궁내막암여자궁내막식육MR동태증강소묘적강화특정급림상개치.방법 회고성분석2012년4월지2014년6월온주의과대학부속제이의원경수술병리증실적14례Ⅰ기자궁내막암화13례자궁내막식육적MRI동태증강특정,대비분석불동조간병조적시간-신호곡선(TIC)류형、각시단(16、32、48、64、109、154、199 s)적신호강도차치、조기상대신호강화솔(ARSIR)、최대상대신호강화솔(MRSIR)、총체상대신호강화솔(SER)화강화봉치시간(TTP).결과 14례Ⅰ기내막암TIC곡선중,Ⅰ형4례,Ⅱ형6례,Ⅳ형4례;13례내막식육중,Ⅲ형3례,Ⅳ형10례.Ⅰ기내막암각기신호강도차치저우정상기층,기중32、48、64、109、154、199 s적차이균유통계학의의(균P ＜0.05).Ⅰ기내막암MRSIR、TTP저우정상기층;SER고우정상기층,차이유통계학의의(P＜0.01).Ⅰ기내막암각기신호강도차치저우내막식육,기중32、48、64、109、154、199 s적차이균유통계학의의(균P ＜0.05).Ⅰ기내막암MRSIR、TTP저우내막식육;SER고우내막식육,차이균유통계학의의(P＜0.01).결론 3.0TMR동태증강검사능정량분석Ⅰ기자궁내막암급내막식육재각계단적강화특점,기정량수거급TIC곡선류형대이자적진단급감별진단구유교대개치.
Objective To comparatively analyze the dynamic contrast-enhanced (DCE) characteristics and its clinical value between stage-Ⅰ endometrial carcinomas versus polyps with 3.0T magnetic resonance imaging (MRI).Methods A retrospective analysis was performed for DCE-MRI manifestation in 27 patients with histopathologically proved endometrial masses.There were stage-Ⅰ endometrial carcinomas (n =14) and polyps (n =13).The signal intensity of solid component was measured and time-intensity curves (TIC) was obtained.TIC of lesions were divided into 4 subtypes.The time-to-peak (TTP) and signal intensity (SI) were determined from TICs.The arterial phase relative signal increase ratio (ARSIR),maximal relative signal increase ratio (MRSIR),signal enhancement ratio (SER) and signal intensity difference values (D) of each phase were calculated based on TIC curves respectively.Results The TIC of 14 stage-Ⅰ endometrial carcinomas included type Ⅰ (n =4),type Ⅱ (n =6) and type Ⅳ (n =4).The TIC of 13 polyps included type Ⅲ (n =3) and type Ⅳ (n =10).The D values in each phase of 14 stage-Ⅰ endometrial carcinomas were lower than normal muscle layers.There were statistic differences(P ＜ 0.05) of each phase including 32,48,64,109,154,199 s.For stage-Ⅰ endometrial carcinomas,MRSIR and TTP were lower(P ＜ 0.01)than normal muscle layers while SER was higher(P ＜ 0.01) than normal muscle layers.The each phase of D of stage-Ⅰ endometrial carcinomas were lower than polyps,and there were statistic differences(P ＜ 0.05) of each phase including32,48,64,109,154,199 s.The MRSIR and TTP of stage-Ⅰ endometrial carcinomas were lower(P ＜ 0.01) than those of polyps while SER was higher(P ＜ 0.01) than polyps.Conclusion DCE-MRI can reflect enhanced features of stage-Ⅰ endometrial carcinomas and polyps during different phases quantitatively.Parameters of DCE-MR and TIC are helpful in the diagnosis and differential diagnosis of stage-Ⅰ endometrial carcinomas versus polyps.