不同月经状态下正常子宫ADC值变化
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摘要
目的探讨不同月经状态下正常子宫ADC值的变化特征。方法收集绝经前和绝经后因子宫以外的盆腔器官病变接受MR检查的女性患者78例,根据其月经状态分为月经期(n=18)、卵泡期(n=20)、黄体期(n=20)和绝经后(n=20)。在ADC伪彩图中测量子宫各层结构(内膜、结合带、肌层)的ADC值,分析并比较不同结构、不同月经状态下子宫ADC值的差异。结果相同月经状态下,子宫内膜、结合带、肌层间ADC值总体差异均有统计学意义(P均<0.001),子宫肌层、内膜、结合带ADC值依次降低,两两比较差异均有统计学意义(P均<0.05)。子宫各层结构在不同月经状态的ADC值总体差异均有统计学意义(P均<0.05)。子宫内膜ADC值在月经期、卵泡期和黄体期的两两比较差异有统计学意义(P均<0.05),绝经后与月经期、黄体期有统计学意义(P均<0.05);结合带ADC值在月经期、卵泡期与黄体期两两比较差异有统计学意义(P均<0.05),绝经后与黄体期差异有统计学意义(P<0.05);肌层ADC值在绝经后与月经期、卵泡期和黄体期差异均有统计学意义(P均<0.05)。结论不同月经状态下正常子宫各层结构ADC值变化较大。利用ADC值评判子宫疾病时,应考虑不同月经状态下的基线ADC值变化。
Objective To investigate the changes of ADC value of normal uterus during different menstrual conditions.Methods Totally 78 premenopausal and postmenopausal women with pelvic diseases except for uterus who underwent MR examination were divided into menstrual phase(n=18),follicular phase(n=20),luteal phase(n=20)and menopause(n=20)according to the menstrual conditions.ADC value of uterine structures(endometrium,junctional zone and myometrium)were measured in ADC pseudo-color map,and the differences of ADC value were compared among different uterine structures and different menstrual conditions.Results Under the same menstrual condition,the differences of ADC value among endometrium,junctional zone and myometrium were statistically significant(all P<0.001).ADC value of myometrium,endometrium and junctional zone decreased in turn,and the differences were statistically significant between every 2 groups(all P<0.05).The differences of ADC value for each uterine structures among different menstrual conditions were statistically significant(all P<0.05).ADC values of endometrium showed significant differences between every 2 of menstrual,follicular and luteal phases,menopause and menstrual phase,as well as menopause and luteal phase(all P<0.05).ADC value of junctional zone showed significant differences between every 2 of menstrual,follicular and luteal phases,menopause and luteal phase(all P <0.05).The differences of ADC values of myometrium between menopause and menstrual,follicular,luteal phases were statistically significant(all P<0.05).Conclusion A wide variation of ADC value in uterine is observed during different menstrual conditions.The changes of baseline ADC value should be considered when interpreting uterine diseases.
Objective To investigate the changes of ADC value of normal uterus during different menstrual conditions.Methods Totally 78 premenopausal and postmenopausal women with pelvic diseases except for uterus who underwent MR examination were divided into menstrual phase(n=18),follicular phase(n=20),luteal phase(n=20)and menopause(n=20)according to the menstrual conditions.ADC value of uterine structures(endometrium,junctional zone and myometrium)were measured in ADC pseudo-color map,and the differences of ADC value were compared among different uterine structures and different menstrual conditions.Results Under the same menstrual condition,the differences of ADC value among endometrium,junctional zone and myometrium were statistically significant(all P<0.001).ADC value of myometrium,endometrium and junctional zone decreased in turn,and the differences were statistically significant between every 2 groups(all P<0.05).The differences of ADC value for each uterine structures among different menstrual conditions were statistically significant(all P<0.05).ADC values of endometrium showed significant differences between every 2 of menstrual,follicular and luteal phases,menopause and menstrual phase,as well as menopause and luteal phase(all P<0.05).ADC value of junctional zone showed significant differences between every 2 of menstrual,follicular and luteal phases,menopause and luteal phase(all P <0.05).The differences of ADC values of myometrium between menopause and menstrual,follicular,luteal phases were statistically significant(all P<0.05).Conclusion A wide variation of ADC value in uterine is observed during different menstrual conditions.The changes of baseline ADC value should be considered when interpreting uterine diseases.
引文
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[13]Masui T,Katayama M,Kobayashi S,et al.Changes in myometrial and junctional zone thickness and signal intensity:Demonstration with kinematic T2-weighted MR imaging.Radiology,2001,221(1):75-85.
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[15]Kido A,Kataoka M,Koyama T,et al.Changes in apparent diffusion coefficients in the normal uterus during different phases of the menstrual cycle.Br J Radiol,2010,83(990):524-528.
[2]Woo S,Cho JY,Kim SY,et al.Histogram analysis of apparent diffusion coefficient map of diffusion-weighted MRI in endometrial cancer:A preliminary correlation study with histological grade.Acta Radiol,2014,55(10):1270-1277.
[3]Nougaret S,Reinhold C,Alsharif SS,et al.Endometrial cancer:Combined MR volumetry and diffusion-weighted imaging for assessment of myometrial and lymphovascular invasion and tumor grade.Radiology,2015,276(3):797-808.
[4]Tsili AC,Argyropoulou MI,Tzarouchi L,et al.Apparent diffusion coefficient values of the normal uterus:Interindividual variations during menstrual cycle.Eur J Radiol,2012,81(8):1951-1956.
[5]Tsili AC,Ntorkou A,Vrekoussis T,et al.Variations of ADC of normal uterine zones in postmenopausal and reproductive women.Hell J Radiol,2016,1(1):37-45.
[6]Jiménez-Ayala M,Jiménez-Ayala B.Cytology of the normal endometrium-cycling and postmenopausal//endometrial adenocarcinoma:Prevention and early diagnosis.[2008-02-14].https://www.karger.com/Article/Pdf/117494
[7]Dutta M,Talukdar KL.A histological study of uterus in reproductive and postmenopausal women.National Journal of Clinical Anatomy,2015,4(1):17-25.
[8]Masroor I,Zeeshan M,Afzal S,et al.Diffusion weighted MRimaging(DWI)and ADC values in endometrial carcinoma.J Coll Physicians Surg Pak,2010,20(11):709-713.
[9]Cao K,Gao M,Sun YS,et al.Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness.Eur J Radiol,2012,81(8):1926-1930.
[10]Beddy P,Moyle P,Kataoka M,et al.Evaluation of depth of myometrial invasion and overall staging in endometrial cancer:Comparison of diffusion-weighted and dynamic contrast-enhanced MR imaging.Radiology,2012,262(2):530-537.
[11]Bharwani N,Miquel ME,Sahdev A,et al.Diffusion-weighted imaging in the assessment of tumour grade in endometrial cancer.Br J Radiol,2011,84(1007):997-1004.
[12]Kuang F,Chen Z,Zhong Q,et al.Apparent diffusion coefficients of normal uterus in premenopausal women with 3TMRI.Clin Radiol,2011,68(5):455-460.
[13]Masui T,Katayama M,Kobayashi S,et al.Changes in myometrial and junctional zone thickness and signal intensity:Demonstration with kinematic T2-weighted MR imaging.Radiology,2001,221(1):75-85.
[14]Boodhwani M,Sellke FW.Myometrium:Another candidate for cell-based myocardial angiogenesis.Am J Physiol Heart Circ Physiol,2006,291(5):H2039-H2040.
[15]Kido A,Kataoka M,Koyama T,et al.Changes in apparent diffusion coefficients in the normal uterus during different phases of the menstrual cycle.Br J Radiol,2010,83(990):524-528.