| Purpose1,To investigate the effect of echo time(TE) on the display of junctional zone of the uterine and the image quality and to search a better scan protocol.2,To investigate the value of magnetic resonance imaging in the preoperative assessment of stage I endometrial carcinoma.3,To compare the apparent diffusion coefficient (ADC) values of the endometrium in different menstrual cycle and different endometrial diseases and to evaluate the usefulness of quantitative analysis of apparent diffusion coefficient in the MRI diagnosis of early stage endometrial carcinoma.Material and methods1,Three different TE of the sagittal T2WI imaging of the 9 healthy volunteers were set as 120ms,140ms,160ms; and three different FOV of the oblique axial T2WI were set as 20cm×20cm,26cm×26cm,30cm×30cm. The quality of the different images and the display of the junctional zone of the uterine were compared.2,11 healthy volunteers had MR examination both in the proliferative phase and secretory phase in a single menstrual cycle. ADC values were calculated on an ADW4.3 workstation and ADC map was reconstructed automatically. The ADC values of the endometrium were measured. The differences of ADC values between the two phases were compared.3,We retrospectively analyzed the MR imaging of 18 cases with pathologically confirmed stage I endometrial carcinoma, searching for a acceptable scan protocol, and the diagnosis accuracy were calculated compared to the surgicopathologic findings.4,We investigated 8 endometrial cancers which had DWI images together with histologically verified to 4 endometrial polyps,3 atrophic endometrium,6 Proliferative endometrium and 2 Secretory endometrium. ADC values were calculated on an ADW4.3 workstation and ADC map was reconstructed automatically. The ADC values were measured both in the endometrium and endometrial diseases. The differences of ADC values between different endometrial diseases were compared.Results1,Although prolonging the TE value and decreasing the FOV decreases the SNR, when the TE value was 140ms and the FOV was 26cm×26cm, the display of junctional zone was most clear.2,In the control group, average value of endometrium proliferative phase (1.28±0.05)×10-3mm2/sec, secretory phase (1.58±0.11)×10-3mm2/sec, respectively. Paired t-test was used, the results showed statistic difference between proliferative phase and secretory phase(P< 0.01).3,Sagittal scan combined with oblique axial and oblique coronal scan has a high accuracy in the judge of myometrial infiltration of endometrial carcinoma, and enhanced scan may also be some helpful. MR imaging made correct assessment in 76.9%of patients with myometrial infiltration of less than 50%and in 100%of patients with myometrial infiltration of 50%or greater.4, Average value of endometrial cancer is (0.95±0.10)×10-3mm2/sec, endometrial polyp is (2.03±0.42)×10-3mm2/sec, atrophic endometrium is (1.49 ±0.18)×10-3 mm2/sec, Proliferative endometrium is (1.47±0.16)×10-3mm2/sec, Secretory endometrium is (1.90±0.18)×10-3mm2/sec. In the experimental group, the results calculated by one way ANOVA showed statistic difference between endometrial cancer and endometrial polyp and atrophic/proliferative/secretory endometrium.Conclusion1,Although prolonging the TE value and decreasing the FOV decreased the SNR, when the TE value was 140ms and the FOV was 26cm x 26cm, the display of junctional zone was most clear, which help the preoperative evaluation of endometrial carcinoma.2,MR Sagittal scan combined with oblique axial and oblique coronal scan has a high accuracy in the judge of myometrial infiltration of endometrial carcinoma, it is of great value in preoperative staging of stage I endometrial carcinoma.3,Magnetic Resonance Diffusion Weighted Imaging (DWI) provide a new method in the diagnosis of endometrial diseases. Quantitative ADC analysis has important value in the differentiation diagnosis of benign and malignant lesions of the endometium, especially for the early diagnosis of endometrial cancer.
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