Applied Research Of Uterine Myometrium Based On The Technology Of Magnetic Resonance Diffusion Weighted Imaing

PART1THE STUDY OF RELATION BETWEEN THE INTESTINAL PREPARATION AND UTERINE DIFFUSION WEIGHTED IMAGING MAGNETIC SUSCEPTIBILITY ARTIFACTObjective:To investigate the influence of bowel preparation for uterine diffusion weighted imaging magnetic susceptibility artifact.Methods:60 healthy women (age range,23-45 years old) were randomly divided into two groups (no bowel preparation group and bowel preparation group),each group had 30 subjects, and then we scanned every subjects for T2WI(axial and sagittal plane) and DWI, finally every image was evaluated by two doctors in a double-blind way.Result:In no bowel preparation group, average occurrence rate of predominately air is 65.00%, occurrence rate of predominately fluid is 35.00%; In bowel preparation group, mean occurrence rate of predominately air is 23.33%, occurrence rate of predominately fluid is 76.67%, There was significantly statistical differences in two groups (P1\i=0.001, P2=0.002). when intestinal tract was predominantly air, the average positive rate for uterine DWI susceptibility artifact was 82.91%; when intestinal tract was predominantly fluid, the average positive rate for uterine DWI susceptibility artifact was 13.46%, There was significantly statistical differences between air group and fluid group (Pi=0.000,P2=0.000).Conclusion:Bowel preparation can decrease susceptibility artifact before uterine DWI examination, and then improve the quality of uterine DWI, This is beneficial for the uterine histological study, and diagnosis, monitoring, assessment after treatment in uterine disease.PART 2DWI OF THE NORMAL UTERINE MYOMETRIUM: SPATIAL AND TEMPORAL CHANGE OF ADC VALUESObjective:To explore the difference of myometrial ADC values in corpus and cervix uteri of healthy women from menopausal phase to reproductive phases (proliferating phase, secretory phase).Methods:Totally of 90 healthy women (30 in menopausal phase,30 in proliferating phase,30 in secretory phase) underwent MRI and ADC values were measured and compared at the corpus and cervix.Results:There were statistical significant difference in myometrial ADC values of corpus uteri during the menopausal phase ([1.23±.31]×10-3 mm2/s), secretory phase ([1.86±0.13]×10-3 mm2/s) and proliferating phase ([1.72±0.18]×10-3 mm2/s)(F=67.30, P<0.001); Statistical significant difference of myometrial ADC values had also been found in cervix during the menopausal phase([1.19±0.37]×10-3 mm2/s), proliferating phase ([1.82±0.18]×10-3 mm2/s) and secretory phase ([1.68±0.16]×10-3 mm2/s) (F=47.89, P<0.001). However no statistical difference of myometrial ADC values had been found between the corpus and the cervix of uterus in menopausal phase, proliferating phase and secretory phase (all P>0.05).The ADC values of myometrium in menopausal phase were significantly lower than that in proliferating phase and secretory phase (both P<0.05), and the ADC values of myometrium in proliferating phase was significantly lower than that in secretory phase (P<0.05).Conclusion:Variations occurring in the myometrial ADC values of healthy women are important reference value for the radiologists to diagnose the disease of uterus, differential diagnosis between the physical change and pathological change, establish invasive range of tumor and follow-up after treatment of diseases.PART 3REPRODUCIBILITY OF APPARENT DIFFUSION COEFFICIENT IN THE NORMAL MYOMETRIUM OF UTERUS DURING DIFFERENT MENSTRUAL CYCLESObjective:To explore consistency of the intra-and inter-observer and reproducibility of the normal myometrial ADC values.Methods:34 healthy women (18 in the proliferating phases; 16 in the secretory phases) were underwent two MR scanning sessions with an interval of one menstrual cycle. Two radiologists measured the ADC values of normal myometrium independently. ADC values were measured twice with an interval of one week for each radiologist in each session for test of intra-observer consistency, then take the average values of two measurements in normal uterine myometrial ADC values for each radiologist and each session for test of inter-observer consistency and reproducibility of myometrial ADC values in two sessions.Results:Intra-observer consistency of myometrial ADC values in were good, their intraclass correlation coefficients (ICCs) were 0.95,0.82, 0.85 and 0.89 respectively; inter-observer consistency in each session were also good, their intraclass correlation coefficients (ICCs) were 0.92 and 0.88 respectively. The myometrial ADC values in the secretory phase were larger than these in the proliferating phase in each session (P<0.05). There were no statistical difference between first mission and second mission in the myometrial ADC values of proliferative and secretory phase (P>0.05). Analysis of Bland-Altman found that the 95%confidence intervals in the proliferating phase were-14.3%-13.6% and-11.5%～12.8%. But in the secretory were-7.6%～7.0% and-7.7%～7.8%. Reproducibility of myometrial ADC value in secretory phase was better than that in proliferating phaseConclusion:The intra-and inter-observer consistency of myometrial ADC values are satisfied, these provide more evidence for widely applying in clinic. However, reproducibility of myometrial ADC value in secretory phase was better than that in proliferating phase.