The Value Of Functional Magnetic Resonance Imaging In The Identification Of Endometrial Cancer And Endometrial Benign Disease

ObjectiveTo observe the magnetic resonance imaging（MRI）characteristics of endometrial cancer and endometrial benign disease using diffusion weighted imaging（DWI）and dynamic contrast-enhanced MRI（DCE-MRI）.To discuss the value of apparent diffusion coefficient（ADC）in identification stage Ia endometrial cancer and endometrial benign disease.To explore dynamic enhanced pattern and its differential diagnosis value between endometrial benign and malignant lesions.To study the relationship between the lesions and laboratory examination.MethodsThe study included 53 cases of stage Ia endometrial carcinoma and 38 cases of endometrial benign disease all pathologically confirmed.All patients underwent convent-ional MRI scans,DWI（b=1000s/mm²）and DCE-MRI scans on 3.0 T MR scanner.MR characteristics were analyzed and compared between the two groups of cases.Images were transmitted to the post-processing workstation and the ADC values of lesions were measured.Based on the DCE-MRI,the dynamic enhancement curves and the quantitative data were obtained.The data were statistically analyzed by using SPSS17.0 software with P<0.05.Results1.The signal intensity on T₁WI of stage Ia endometrial cancer was equal to endometrial benign disease.They all showed high signal on T₂WI and DWI.The two kinds lesions were difficult to identify based on signal intensity.2.The ADC value of stage Ia endometrial cancer was（0.804±0.122）×10^-3mm²/s and endometrial benign disease was（1.221±0.204）×10^-3mm²/s with statistical difference（P<0.05）between them.3.The TIC of stage Ia endometrial cancer showed rapid inflow and slightly washout pattern（33 cases）or rapid inflow and long platform pattern（20 cases）,with the enhancement rate of5.522±3.724.While,the TIC of endometrial benign disease presented rapid inflow and slightly washout pattern（24 cases）or rapid inflow and long platform pattern（14 cases）with the enhancement rate of 3.115±1.382.There was statistical difference between the two enhancement rates,but not between the two enhanced patterns,that is to say,the enhanced pattern was not related to pathological type.4.The positive rates of CA-125,CA-199,CA-153,and CA-724 were 21.1%,17.4%,10.5%and 14.3%respectively in stage Ia endometrial cancer.And the positive rates of the four indexes were 10%,12.5%,6.7%,and 21.4%respectively in endometrial benign disease.There was no statistical difference between the indexes of endometrial cancer and endometrial benign disease.ConclusionDWI can reflect the pathological changes of endometrium,and show the location and scope of the endometrial lesions.ADC value is worthy of identifying stage Ia endometrial cancer and endometrial benign disease.DCE-MRI can provide the blood supplying information with quantitative data.The combined MRI,including conventional MRI,DWI and DCE-MRI can offer more information to the diagnosis of endometrial carcinoma.