摘要
目的:探讨宫颈癌在MRI体素不相干运动扩散加权成像(IVIM-DWI)上的特点及临床价值。方法:对经病理证实的、未经放化疗的40例宫颈癌患者行9个b值(0~1000 s/mm^2)IVIM-DWI扫描。测量并计算宫颈癌组织和自体子宫肌层的单指数成像ADC值,IVIM-DWI定量参数值,包括纯扩散系数(D)、伪扩散系数(D*)和灌注分数(f)。按子宫颈癌组织学及临床分期进行分组,用统计学方法分析比较各组子宫颈癌和正常子宫肌层的上述参数。结果:宫颈癌组ADC、f、D、D*值分别为(0.76±0.13)×10^-3mm^2/s、(10.78±4.42)%、(0.88±0.35)×10^-3mm^2/s、(16.31±15.39)×10^-3mm^2/s,均低于正常子宫肌层组(P<0.05)。宫颈低分化鳞癌组ADC、f、D、D*值分别为(0.74±0.14)×10^-3mm^2/s、(10.85±6.02)%、(0.93±0.39)×10^-3mm^2/s、(22.12±20.69)×10^-3mm^2/s;宫颈中分化鳞癌组ADC、f、D、D*值分别为(0.78±0.11)×10^-3mm^2/s、(12.37±5.01)%、(0.86±0.25)×10^-3mm^2/s、(13.71±9.12)×10^-3mm^2/s;宫颈腺癌组ADC、f、D、D*值分别为(0.76±0.16)×10^-3mm^2/s、(7.68±3.76)%、(0.80±0.41)×10^-3mm^2/s、(8.82±3.88)×10^-3mm^2/s;各组数值两两比较无统计学意义(P>0.05)。早期宫颈癌组ADC、f、D、D*值分别为(0.76±0.13)×10^-3mm^2/s、(7.82±4.73)%、(0.87±0.25)×10^-3mm^2/s、(17.39±20.88)×10^-3mm^2/s;晚期宫颈癌组ADC、f、D、D*值分别为(0.75±0.14)×10^-3mm^2/s、(12.21±5.22)%、(0.87±0.39)×10^-3mm^2/s、(15.78±12.39)×10^-3mm^2/s。早期宫颈癌组f值明显低于晚期宫颈癌组(P=0.014),有统计学意义;ADC、D、D*值在两组间无统计学意义(P>0.05)。结论:在IVIN-DWI定量参数分析中,宫颈癌组ADC、f、D、D*值与正常子宫肌层具有不同,宫颈低分化鳞癌组、宫颈中分化鳞癌组及宫颈腺癌无差别。早期宫颈癌f值明显低于晚期宫颈癌组。研究结果显示IVIM参数能定量反映宫颈癌组织特性,在宫颈癌MR诊断中有一定的应用价值。
Objectives:To evaluate histologic features and clinical values of IVIM-DWI in cervical cancer.Methods:40 patients suffered from cervical cancer experienced reselove IVIM-DWI of 9 b-values(0~1000s/mm^2).All the patients were confirmed by pathology without radiotherapy and chemotherapy.ADC value of single exponential model and quantized value of IVIM-DWI including pure molecular diffusion(D),perfusion-related diffusion(D*),and perfusion fraction(f)were measured and calculated in the lesions of carcinomas and itself myometrium.According to the pathology and clinical stage,cervical cancer patients were grouped.The above parameters in each group were compared by statistics.Results:The ADC value,f,D,D*were(0.76±0.13)×10^-3mm^2/s,(10.78±4.42)%,(0.88±0.35)×10^-3mm^2/s,(16.31±15.39)×10^-3mm^2/s respectively in cervical cancer and were all lower than normal myometrium(P<0.05).The ADC value,f,D,D*were(0.74±0.14)×10^-3mm^2/s,(10.85±6.02)%,(0.93±0.39)×10^-3mm^2/s,(22.12±20.69)×10^-3mm^2/s respectively in poorly differentiated squamous-cell carcinomas and were(0.78±0.11)×10^-3mm^2/s,(12.37±5.01)%,(0.86±0.25)×10^-3mm^2/s,(13.71±9.12)×10^-3mm^2/s respectively in moderately differentiated squamous cell carcinomas and were(0.76±0.16)×10^-3mm^2/s,(7.68±3.76)%,(0.80±0.41)×10^-3mm^2/s,(8.82±3.88)×10^-3mm^2/s respectively in adenocarcinoma.There was no statistical significance between each two groups(P>0.05).The ADC value,f,D,D*were(0.76±0.13)×10^-3mm^2/s,(7.82±4.73)%,(0.87±0.25)×10^-3mm^2/s,(17.39±20.88)×10^-3mm^2/s respectively in early stage carcinomas and were(0.75±0.14)×10^-3mm^2/s,(12.21±5.22)%,(0.87±0.39)×10^-3mm^2/s,(15.78±12.39)×10^-3mm^2/s respectively in late stage carcinomas.The f values of early stage cervical cancer were significantly lower than that of late stage(P=0.014),but other parameters were not statistically significant between the two groups(P>0.05).Conclusions:The ADC value,f,D,D*of cervical cancer are different from normal myometrium.There is no difference among the groups of poorly differentiated squamous-cell carcinomas,moderately differentiated squamous cell carcinomas and adenocarcinoma.The f of cervical cancer in early stage is lower than that in late stage.The IVIM-DWI can reveal features of cervical cancer quantitatively,which can provide application value in MR diagnosis of cervical cancer.
作者
叶瑞婷
邹玉坚
郑晓林
李建鹏
袁灼彬
张坤林
YE Rui-ting;ZHOU Yue-jiang;ZHENG Xiao-lin(Radiological Department,Dongguan People’s Hospital,Dongguan City,Guangdong 523000,China)
出处
《放射学实践》
北大核心
2020年第6期750-755,共6页
Radiologic Practice
基金
东莞市社会科技发展项目(20170715001278)。
关键词
宫颈肿瘤
扩散加权磁共振成像
诊断
鉴别
Uterine cervical neoplasms
Diffusion weighted magnetic resonance imaging
Diagnosis,differential
