摘要
目的探讨宫颈癌MRI动态增强的特征,评价其定量数据及曲线类型的诊断价值。方法回顾性分析经宫颈刮片证实为宫颈癌的40例患者的MRI动态增强表现,选取ROI绘制宫颈癌病灶及邻近正常组织的动态增强时间-信号曲线。测量ROI16、32、48、64和300s的动态早期相对信号增强率(ARSI%)和最大相对信号增强率(MRSI%)并对曲线分型。对不同征象分组间的ARSI%和MRSI%差异行独立样本t检验。结果宫颈癌在动态增强早期明显强化,与周围正常组织对比明显。16S宫颈癌与邻近正常组织ARSI%分别为(1.97±0.55)%及(1.22±0.56)%,差异有统计学意义(t=151.000,P〈0.01)。病灶直径〉3cm组ARSI%为(1.70±0.25)%,MRSI%为(2.26±0.18)%;直径≤3cm组ARSI%和MRSI%分别为(0.57±0.16)%及(0.73±0.04)%,两者差异均有统计学意义(t值分别为5.396及11.595,P〈0.05)。伴有宫旁浸润组ARSI%为(1.69±0.21)%,MRSI%为(2.26±0.11)%,不伴有宫旁浸润组的相应值分别为(0.63±0.23)%及(0.83±0.03)%,差异均有统计学意义(t值分别为4.886及18.358,P〈0.05)。39例宫颈癌表现为Ⅰ型(25例)或Ⅱ型(14例);而邻近正常组织多表现为Ⅲ型(26例)及Ⅱ型(11例),仅2例为Ⅰ型曲线。结论MR动态增强扫描能定量分析宫颈癌在各阶段的强化特点,反映肿瘤的血供状态。动态增强的早期及延迟期可以提高小病灶的检出率,其定量数据ARSI%及MRSI%可以进一步判断预后、指导分期。
Objective To investigate the imaging characteristics of dynamic contrast-enhanced MR imaging (DCE-MRI) in uterine cervical cancer(UCC), and to evaluate the efficacy of DCE-MRI in the diagnosis of UCC. Methods A total of 39 cases of scratch-pathologically confirmed UCC patients with MRI data were analyzed (one ease of carcinoma in situ being negative on MRI was excluded in this study). Time- intensity curves of ROI in pathological regions and adjacent normal regions were obtained and the enhanced rates at different times (16,32,48,64 and 300 s) were calculated. The ARSI% and MRSI% of various groups were compared with t test. Results All the 39 lesions enhanced at 16 s in DCE, and there was maximum signal contrast between lesions and the surrounding normal tissue in the early arterial phase. ARSI% of tumor (1.97 ±0. 55 )% was higher than normal tissue (1.22±0. 56 )%, and there was statistically significant difference between them (t = 151. 000,P 〈 0. 01 ). ARSI% and MRSI% of diameter 〉 3 cm group [ ( 1.70 ± 0. 25 ) % and (2. 26 ± 0. 18 ) % ] were higher than ≤ 3cm group [ (0. 57± 0. 16) % and (0. 73 ±0. 04 )% ]. ARSI% and MRSI% were higher in the peri-uterine tissue infiltration group [(1.69±0.21)% and (2.26±0. 11)%1 than that of confined group[(0.63±0.23)% and (0.83 ±0.03 ) % ] with statistically significant difference (P 〈 0. 05 ). The TIC of the 39 cases with UCC included type Ⅰ in 25 cases (25/39), type Ⅱ in 14 cases ( 14/39), and there was no type Ⅲ cases. The TICs of the surrounding normal tissue were of type Ⅲ (26/39) and type Ⅱ (11/39), and only 2 cases type Ⅰ. Conclusions The DCE-MRI can reflect the blood supply of the UCCs quantitatively. The early arterial phase in DCE-MRI can improve the detection rate of small lesions. The ARSI% and MRSI% may be helpful in some degree in prognostic assessment and staging of the uterine cervical cancer.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第9期973-977,共5页
Chinese Journal of Radiology
基金
2008年大连市科技计划项目科技支撑社会发展示范工程(20080863)
关键词
宫颈肿瘤
磁共振成像
图像增强
Uterine cervical neoplasms
Magnetic resonance imaging
Image enhancement