| 杨 皓,吴勘华,宋 恬,孙荣跃,殷士蒙.磁共振扩散加权成像对宫颈癌诊断价值及其与临床病理特征的关系研究[J].,2019,19(10):1870-1874 |
| 磁共振扩散加权成像对宫颈癌诊断价值及其与临床病理特征的关系研究 |
| Diagnostic Value of Magnetic Resonance Diffusion-weighted Imaging in Cervical Cancer and Its Relationship with Clinicopathological Features |
| 投稿时间：2018-10-12 修订日期：2018-10-31 |
| DOI：10.13241/j.cnki.pmb.2019.10.013 |
| 中文关键词: 磁共振扩散加权成像 宫颈癌 诊断价值 临床病理特征 |
| 英文关键词: Magnetic resonance diffusion-weighted imaging Cervical cancer Diagnostic value Clinicopathological features |
| 基金项目:上海市卫生和计划生育委员会科研项目（2016Y1036） |
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| 中文摘要: |
| 摘要 目的：研究磁共振扩散加权成像（DWI）对宫颈癌的诊断价值及其与临床病理特征的关系。方法：将2016年5月至2018年5月间于本院接受诊治的90例宫颈癌患者作为研究组，其中鳞癌69例，腺癌21例。另选择同期因其他原因来本院行宫颈检查的90例非宫颈癌患者作为对照组，两组患者均接受常规磁共振成像（MRI）平扫及DWI检查。观察两组MRI影像学特征，分别比较研究组和对照组、不同病理分型以及不同临床病理特征宫颈癌患者表观弥散系数（ADC）值，采用受试者工作特征（ROC）曲线评价DWI检查对宫颈癌的诊断价值，并分析宫颈癌患者ADC值与临床病理特征的关系。结果：研究组和对照组的MRI影像学图像全部符合诊断和测量要求，无显著的伪影、变形；研究组患者的病变位在宫颈，其信号特征T1加权像(T1WI)显示为等信号，而T2加权像(T2WI)显示为稍高/高信号，经DWI检查显示为高信号肿块，且边界清晰。研究组患者DWI检查的ADC值低于对照组（P＜0.05）；鳞癌患者DWI检查的ADC值也明显低于腺癌患者（P＜0.05）。ROC曲线结果显示，DWI检查鉴别诊断宫颈癌和非宫颈癌、鳞癌和腺癌的AUC分别为0.912、0.827。无淋巴结转移、临床病理分期为Ⅰ-Ⅱ期、中/高分化以及肿瘤细胞间质占比＜70%的宫颈癌患者ADC值分别高于有淋巴结转移、临床病理分期为Ⅲ-Ⅵ期、低分化以及肿瘤细胞间质占比≥70%的宫颈癌患者（均P＜0.05）。结论：DWI对宫颈癌诊断价值高，且DWI成像参数ADC值和宫颈癌的部分临床病理特征关系密切，能从一定程度上辅助医师了解宫颈癌病理分型、病理分期、分化程度及有无淋巴结转移。 |
| 英文摘要: |
| ABSTRACT Objective: To study the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) in cervical cancer and its relationship with clinicopathological features. Methods: 90 cases of patients with cervical cancer who were treated in our hospital from May 2016 to May 2018 were enrolled as the study group. There were 69 cases of squamous cell carcinoma and 21 cases of adenocarcinoma. Another 90 patients without cervical cancer who underwent cervical examination for other reasons were selected as the control group. The two groups of patients underwent conventional magnetic resonance imaging (MRI) plain scan and DWI examination.The MRI imaging features of the two groups were observed. Apparent diffusion coefficient (ADC) values were compared between the study group and the control group, different pathological types and clinicopathological features of cervical cancer patients. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of DWI in cervical cancer. The relationship between ADC value and clinicopathological features of cervical cancer patients was analyzed. Results: MRI images of the study group and the control group all met the requirements of diagnosis and measurement, without significant artifacts and distortion. The lesions in the study group were located in the cervix, and their signal characteristics T1 weighted imaging (T1WI) showed equal signal. T2-weighted imaging (T2WI) showed slightly high/high signal, and DWI showed a high signal mass, and the boundary was clear. The ADC value of DWI in the study group was lower than that in the control group (P<0.05). The ADC value of DWI in squamous cell carcinoma patients was also significantly lower than that in adenocarcinoma patients(P<0.05). The ROC curve showed that the AUC of DWI in examination for differential diagnosis of cervical cancer and non cervical cancer, squamous cell carcinoma and adenocarcinoma were 0.912 and 0.827 respectively. The ADC values of cervical cancer patients with no lymph node metastasis, stage I-II, medium/high differentiation and intercellular proportion of tumor cells＜70% were higher than those of cervical cancer patients with lymph node metastasis, stage III-VI, poorly differentiation and intercellular proportion of tumor cells≥70%(P<0.05). Conclusion: DWI has a high diagnostic value for cervical cancer. DWI imaging parameters ADC value is closely related to the clinicopathological features of cervical cancer. To some extent, it can help doctors to understand the pathological classification, clinicopathological stage, degree of differentiation and lymph node metastasis of cervical cancer. |
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