1.5T磁共振成像系统平扫联合扩散加权成像在宫颈癌临床分期中应用价值
摘要
目的探讨1.5T磁共振成像(MRI)平扫+扩散加权成像(DWI)在宫颈癌临床分期中的应用价值。方法选取自2015年7月至2018年7月江汉大学附属医院武汉市第六医院收治的128例宫颈癌患者为观察组,另选取同期在我院体检的32例健康者为健康组。观察两组研究对象的MRI影像学资料,比较正常宫颈与癌组织、不同病理分期宫颈癌影像学指标值,同时分析宫颈癌患者病理诊断结果与MRI平扫、MRI平扫+DWI诊断结果的差异。结果观察组患者表观扩散系数(ADC)显著低于健康组,指数化表观扩散系数(eADC)显著高于健康组,组间比较,差异均有统计学意义(P<0.05)。宫颈癌Ⅱa期、Ⅱb期及Ⅲ+Ⅳ期患者ADC值显著高于Ⅰb期;宫颈癌Ⅲ+Ⅳ期患者ADC值显著高于Ⅱa期、Ⅱb期;宫颈癌Ⅱa期、Ⅱb期及Ⅲ+Ⅳ期eADC值显著低于Ⅰb期;宫颈癌Ⅱb期和Ⅲ+Ⅳ期eADC值显著低于Ⅱa期;宫颈癌Ⅲ+Ⅳ期eADC值显著低于Ⅱb期,组间比较,差异有统计学意义(P<0.05)。MRI平扫+DWI用于宫颈癌分期诊断的准确率略高于MRI平扫,但组间比较,差异无统计学意义(P>0.05)。结论 1.5T MRI平扫+DWI用于宫颈癌临床分期诊断准确性更高,且更有助于鉴别诊断正常宫颈和宫颈癌组织。
引文
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[4] Hauge A,Wegner CS,Gaustad JV,et al.Diffusion-weighted MRI-derived ADC values reflect collagen I content in PDX models of uterine cervical cancer[J].Oncotarget,2017,8(62):105682-105691.
[5] Jalaguier-Coudray A,Villard-Mahjoub R,Delouche A,et al.Value of Dynamic Contrast-enhanced and Diffusion-weighted MR imaging in the detection of pathologic complete response in cervical cancer after neoadjuvant therapy:a retrospective observational study[J].Radiology,2017,284(2):432-442.
[6] Song J,Hu Q,Huang J,et al.Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers[J].Acta Radiol,2019,60(3):388-395.
[7] Valentini AL,Micco M,Gui B,et al.The PRICE study:the role of conventional and diffusion-weighted magnetic resonance imaging in assessment of locally advanced cervical cancer patients administered by chemoradiation followed by radical surgery[J].Eur Radiol,2018,28(6):2425-2435.
[8] Wang YC,Hu DY,Hu XM,et al.Assessing the early response of advanced cervical cancer to neoadjuvant chemotherapy using intravoxel incoherent motion diffusion-weighted magnetic resonance imaging:a pilot study[J].Chin Med J (Engl),2016,129(6):665-671.
[9] Lin M,Yu X,Chen Y,et al.Contribution of mono-exponential,bi-exponential and stretched exponential model-based diffusion-weighted MR imaging in the diagnosis and differentiation of uterine cervical carcinoma[J].Eur Radiol,2017,27(6):2400-2410.
[10] Wang YT,Li YC,Yin LL,et al.Can diffusion-weighted magnetic resonance imaging predict survival in patients with cervical cancer?A meta-analysis[J].Eur J Radiol,2016,85(12):2174-2181.
[11] Moribata Y,Kido A,Fujimoto K,et al.Feasibility of computed diffusion weighted imaging and optimization of b-value in cervical cancer[J].Magn Reson Med Sci,2017,16(1):66-72.
[12] Ho JC,Allen PK,Bhosale PR,et al.Diffusion-weighted magnetic resonance imaging as a predictor of outcome in cervical cancer after chemoradiation[J].Int J Radiat Oncol Biol Phys,2017,97(3):546-553.