Evaluation Of Dynamic MR Imaging And DWI Of 3T MR In Endometrial Carcinoma

Objective:To explore the characteristic findings and the clinical application value of dynamic contrast-enhanced scanning (DCES) and diffusion weighted imaging (DWI) of 3T MR in the normal uterus (NU) and Endometrial Carcinoma (EC).Methods:Twenty-seven female volunteers and Twelve patients with EC underwent conventional MR examination and DWI with b=300,500,800 and 1000 s/mm~2.The signal intensity of the diffusion images and ADC values of ADC map were measured and analyzed and the results of NU and EC were compared. Seventeen volunteers and all 12 patients with EC were examined with DCES using LAVA (Liver Acquisition Volume Acceleration) technique of GE Signa 3.0T MR, which could acquire three-phase scannings during a single breath-hold in 20 seconds. The bolus injection of GD-DTPA (0.2mmol/kg) by high pressure syringe with the speed of 3ml/s was made and then a series of sequences was performed 15s, 45s and 75s respectively after the beginning of the injection. ALL data were processed by Functool 4.4.05 software of the ADW4.3 workstation. Signal intensity-time curves from the endometrium, the subendometrial enhanced zone and the muscular layer of NU and the lesion of EC were drafted.Results:Optimal images with diagnostic quality were obtained in all volunteers and patients. The signal intensity-time curves showed that three layers of NU and the lesion of EC both began to be enhanced in 24s after the injection. The enhancement ratio (2.0250±0.1360) of EC was higher than that (0.9031±0.3524) of the endometrium of NU in 45s after the injection. There was a statistically significant difference of the signal intensity on the diffusion images with different b values of the three layers of NU. The signal intensity of the endometrium was the highest and the outer myometrium the lowest. The difference of signal intensities between junctional zone (JZ) and outer myometrium couldn't be identified by naked eyes. There was also a statistically significant difference of ADC values in the different layers. The ADC value of the outer myometrium was the highest and JZ the lowest. Though the signal intensity between the endometrium of NU and the lesion of EC showed no difference, ADC values of the endometrium was much higher than that of EC.Conclusion:The dynamic enhanced process of the three layers of NU and the lesion of EC can be well depicted with the multi-phase dynamic contrast-enhanced MRI. All signal intenstity-time curves displayed a pattern of rising-keeping-descending. The enhancement ratio of EC was higher than the endometrium of NU in 45 s after the injection. The three layers of NU have different diffusion characteristics. The ADC values decreases with ascending of b value. DWI can more obviously present the lesion of EC and ADC values can help detect the lesion of EC, the signal intensity of which is similar to the endometrial of NU on the diffusion imagings. The combination of LAVA and DWI can increase the assesment sensitivity and accuracy of EC.