| Objective:1?To analyze the changes of the apparent diffusion coefficient?ADC?value and DCE-MRI quantitative parameters(Ktrans,Kep,Ve)of the normal uterine zonal structures and explore physiological mechanism and clinical significance of the changes.2?The difference of ADC value and DCE-MRI quantitative parameter values between normal endometrium and early endometrial carcinoma and its diagnostic efficacy were analyzed in order to provide evidence for early diagnosis of endometrial carcinoma.Methods:Experiment one:Collected the complete information of 60 cases of patients with normal uterine structures who were treated in our hospital from April 2017 to July 2018.All patients were underwent routine MRI?DWI and DCE-MRI scans,and subjects were divided into proliferative phase?n=20??secretory phase?n=20?and menopause?n=20?.ADC?Ktrans?Kepp and Ve values of uterine structures?endometrium,junctional zone and myometrium?were measured in ADC pseudo-color map and quantitative parameter pseudo-color maps.One-way ANOVA was used to analyze the differences of ADC value and DCE-MRI quantitative parameter value among different uterine structures and different menstrual conditions,and SNK-q test was used for further comparison.Coefficient of variation was used to compare the dispersion of ADC value and DCE-MRI quantitative parameter for each uterine structures among different menstrual conditions.Experiment two:Collected the complete information of 30 cases of early endometrial cancer patients who were newly diagnosed in our hospital from April 2017 to July 2018.All cases were confirmed by postoperative pathology and underwent routine MRI?DWI and DCE-MRI scans.ADC?Ktrans?Kepp and Ve values of uterine structures were measured in ADC pseudo-color map and quantitative parameter pseudo-color maps.The differences of ADC,Ktrans,Kep and Ve in normal endometrium group and early endometrial carcinoma group were compared by independent samples t-test.Receiver operating characteristic?ROC?curve was used to test the diagnostic power of ADC and DCE-MRI parameters for normal endometrium and early endometrial cancer.Results:Experiment one:1?Under the same menstrual condition,the differences of ADC?Ktrans,Kep and Ve values among endometrium,junctional zone and myometrium were statistically significant?all P<0.05?,and the differences of ADC?Ktrans and Kep were statistically significant between every 2 groups?all P<0.05?.The differences of Ve values for each uterine structures during menopause were statistically significant?all P<0.05?.Ve value of proliferative phase and secretory phase showed significant differences between every2 structures,myometrium and endometrium,myometrium and junctional zone?all P<0.05?.2?The ADC?Ktrans and Kep values of endometrium and junctional zone in different menstrual conditions were statistically significant,and the differences were statistically significant between every 2 menstrual?all P<0.05?.The Ve value of endometrium in different menstrual conditions were no statistically significant?P>0.05?.The Ve values of junctional zone in different menstrual conditions were statistically significant,and the differences were statistically significant between every 2 of menstrual,menopause and proliferative phase,menopause and secretory phase?all P<0.05?.The ADC?Ktransrans Kep and Ve values of myometrium in different menstrual conditions were statistically significant,and the differences were statistically significant between every 2 of menstrual,menopause and proliferative phase,menopause and secretory phase?all P<0.05?.3?The variations of ADC?Ktrans?Kep and Ve value were larger in different menstrual conditions.CV value of ADC?Ktrans value of uterine structures were the highest in proliferative phase and menopause.CV value of Kep?Ve value of endometrium were the highest in proliferative phase and secretory phase.CV value of Kep?Ve value of junctional zone were the highest in menopause.CV value of Kep?Ve value of myometrium were the highest in menopause and secretory phase.Experiment two:1?ADC value of early endometrial cancer was lower than endometrium of menopause,and there was significant difference?P<0.05?.Ktrans?Ve value of early endometrial cancer were higher than endometrium of secretory phase,and there was significant difference?P<0.05?.Kep values were consistent in both groups,and the difference was not statistically significant?P>0.05?.2?The ADC value of endometrium of menopause and early endometrial cancer were analyzed by ROC curve.The area under the ADC corresponding curve was 0.992,and the diagnostic efficiency was higher.When the ADC cut off was 0.92×10-3 mm2/s,the diagnostic sensitivity was 100%and the specificity was 90%.The Ktrans?Ve value of endometrium of secretory phase and early endometrial cancer were analyzed by ROC curve.The area under the Ve corresponding curve was 0.910,and the diagnostic efficiency was higher.When the Ve cut off was 0.43,the diagnostic sensitivity was73.3%and the specificity was 100%.Conclusion:1?A wide variation of ADC?Ktrans,Kep and Ve value in uterine was observed during different menstrual conditions,The baseline ADC and quantitative parameter values changes should be considered when interpreting uterine diseases.2?ADC?Ktrans and Ve value contribute to the diagnosis of early endometrial cancer,and ADC?Ve value have high diagnostic efficiency.Therefore,DWI and DCE-MRI scan have important value in early diagnosis of endometrial cancer. |
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