RESUMO
The purpose of this study was to evaluate diagnostic efficiency of methods of diffusion-weighted imaging (DWI) in the diagnosis of diseases of the body the uterus at the high and ultra high field MRI (1,5T1, 3,OT1). In total we examined 150 patients. In 72 patients (48%) there were histologically verified malignant changes; of these 70 patients (46.7%) had endome- trial cancer (EC), 2 (1.3%)--uterine sarcoma. 40 EC patients (57.2%) had of Stage I, 15 patients (21.4%)--Stage II, 11 patients (15.7%)--Stage III, and 4 patients (5.8%) of--stage IV. 48 patients (32%) had benign processes of the endometrium (uterine fibroids--27 patients, endometrial hyperplasia--12 patients, endometrial polyps--9 patients). The control group consisted of 30 (20%) healthy patients. All patients underwent MRI examination of the pelvic organs into high and ultra-high MRI (1,5T1, 3,0T1). All patients were required performance of SP DWI (diffusion-weighted images) in 2 projections (Ax and Sag) with different diffusion factors (50-500-1100). MRI data using DWI were compared with surgical material. To our opinion modern MRI techniques allow to reliably determine the size of the pathological process, its location, the extent of the parameters for endometrial cancer, as well as the degree of involvement in the pathological process of the bladder and rectum, to assess the condition of the pelvic lymph nodes. MRI, supplemented DWI, allowed differentiating benign and malignant lesions of the uterus. MRI data corresponded to a post mortem conclusion in the case, specificity 86%, sensitivity of 92% and a diagnostic accuracy of 91%, which significantly improved the diagnostic accuracy of a standard MRI. Thus the method DWI MRI using modern software improves the differential diagnosis of diseases of the body uterus, can reliably assess the extent of the pathological process, to fully assess the invasion of parametrial tissue, provide a comprehensive assessment of the status of the lymph nodes.
