目的磁共振多期动态增强扫描 及扩散加权成像在子宫内膜癌Ia期与子宫 内膜增生的对比研究。方法 收集从2016 年1月到2018年2月我院经病理证实为宫颈 内膜癌Ia初诊患者共20例、子宫内膜增生 患者19例的常规磁共振、扩散加权成像及 多期动态增强图像。对子宫内膜癌及子宫 内膜增生病灶与手术病理对照研究。结果 20例子宫内膜癌Ia期，子宫内膜样腺癌18 例、浆液性癌2例，19例子宫内膜增生。 DWI测得子宫内膜癌患者原发灶的平均ADC 值(0.93±0.16)×10-3mm2 /s低于子宫内膜 增生(1.36±0.31)×10-3mm2 /s，二者之间 的差异有统计学意义(P<0.05)。DWI及DCE 在诊断子宫内膜癌Ia期均与手术病理结果 有较好的一致性(P<0.05),DWI的准确略高 于DCE。DWI与DCE图两者结合在诊断子宫 内膜增生中的准确率优于DCE和DWI图像。 结论 DCE、DWI序列在鉴别子宫内膜癌Ia 期与子宫内膜增生中可作为常规磁共振序 列的有利补充。

Objective To evaluate the clinical value of Dynamic contrast-enhanced MRI and diffusion-weight in endometrial carcinoma(stage Ia) and endometrial hyperplasia. Methods Routine magnetic resonance imaging (MRI), Dynamic contrast-enhanced MRI and DWI images of 20 cases of endometrial carcinoma (stage Ia) and 19 cases of endometrial hyperplasia confirmed by pathology in our hospital from January 2016 to February 2018 were collected. Endometrial carcinoma and endometrial hyperplasia were compared with surgical pathology. Results Twenty consecutive female patients with stage Ia endometrial cancer (18 endometrioid adenocarcinomas, 2 serous carcinomas), and We successfully obtained good image quality from all cases of imaging. The mean ADC value of stage Ia endometrial cancer (n=20)was (0.93±0.16)×10-3mm2 /s, which was significantly lower than that of uterine endometrial hyperplasia (n=19) was (1.36±0.31)×10-3mm2 /s,P=0.00<0.05]. The accuracy of stage Ia endometrial cancer were consistency with pathology(P<0.05), the accuracy of DWI was90%, which was better than DCE, and the accuracy of stage Ia was 85%. Conclusion DCE and DWI sequences can be used as a useful supplement to conventional MRI in differentiating endometrial carcinoma (stage Ia) and endometrial hyperplasia.