3.0T磁共振弥散加权成像在宫颈癌诊断中的应用

目的探讨3.0 T磁共振弥散加权成像(DWI)在宫颈癌诊断中的应用价值,探讨宫颈癌表观弥散系数(ADC)值与临床病理之间的相关性。方法经妇科常规检查、超声等证实排除子宫颈病变者20例,经宫颈活检或手术病理证实的宫颈癌患者94例,所有病例均行常规MRI及DWI扫描(b=0、1 000 s/mm2),分别测量正常子宫颈内膜ADC值、子宫颈癌ADC值。对所得数据进行统计分析。结果宫颈癌病例组病灶的平均ADC值为(0.827 1±0.148 6)×10-3 mm2/s,明显低于正常子宫颈内膜的平均ADC值(1.526 4±0.068 7)×10-3 mm2/s];应用ROC曲线分析得出宫颈癌最佳ADC诊断阈值为1.284×10-3 mm2/s,其灵敏度为100%,特异性为98.9%。宫颈鳞癌平均ADC值为(0.805 4±0.120 1)×10-3 mm2/s,宫颈腺癌平均ADC值为(0.985 0±0.166 1)×10-3 mm2/s,两者差异有统计学意义(P<0.05);宫颈鳞癌不同病理分级平均的ADC值:G1级(0.949 4±0.083 6)×10-3 mm2/s,G2级(0.816 9±0.099 4)×10-3 mm2/s,G3级(0.706 7±0.087 8)×10-3 mm2/s,两两之间差异均有统计学意义(均P<0.05);ADC值与病理分级之间呈显著负相关(r=-0.616,P=0.000)。结论 DWI有助于宫颈癌的诊断,并对宫颈癌的病理分型、分级有一定的辅助诊断作用。

The application value of diffusion weighted imaging in diagnosing uterine cervix cancer at 3.0 T

Objective To investigate the diagnostic value of 3.0 T diffusion weighted imaging（DWI） for uterine cervix cancer. This study was to assess the value of DWI in indicating the pathological type and pathological grading with cervical cancer. Methods Conventional and DWI （b=0, 1 000 s/mm2） were performed in 94 consecutive females with pathologically proven uterine cervix cancer and 20 females with normal uterine cervix. The ADC value of normal uterine cervix and cervix cancer were measured. Statistical analysis was performed on the date collected. Results The mean ADC value of cervix cancer （0.827 1±0.148 6）×10-3 mm2/s] was significantly lower than normal uterine cervix （1.526 4± 0.068 7）×10-3 mm2/s]. With ROC cut point setting to 1.284×10-3 mm2/s, the diagnostic sensitivity and specificity was 100%and 98.9%. The mean ADC value of squamous carcinoma （0.805 4±0.120 1）× 10-3 mm2/s] was lower than that of adenocarcinoma （0.985 0±0.166 1）×10-3 mm2/s]. And the mean ADC value for each pathological grade was G1 （0.949 4±0.083 6）×10-3 mm2/s, G2 （0.816 9±0.099 4）×10-3 mm2/s, G3 （0.706 7±0.087 8）×10-3 mm2/s, and there was statistically significant difference between different pathological grades. The ADC value of uterine cervix cancer correlates negatively with the grading of tumor. Conclusion DWI has a potential ability to differentiate between cervix cancer and normal uterine cervix, and it can indicate the pathological type of uterine cervix and provide a new method for evaluating the pathological grading of tumor.