探讨DWI在宫颈鳞状细胞癌诊断中的价值

Investigation on the diagnostic value of diffusion weighted imaging(DWI)for cervical squamous cell carcinoma

目的探讨扩散加权成像(DWI)在宫颈鳞癌诊断中的价值,并分析ADC值与病理分级相关性。方法收集47例宫颈鳞癌,宫颈病灶最小直径大于或等于3cm,于MRI检查时未做过任何治疗;收集同期23例正常宫颈病例作为对照组。均行常规MRI及DWI(b值取0、500、1000s/mm2),分别观察DWI信号强度,并测量ADC值。分析正常宫颈与宫颈癌间关系,并将宫颈癌病灶体积与宫颈癌ADC值、宫颈癌ADC值与宫颈癌细胞分化程度进行比对。结果正常宫颈ADC值为(1.416±0.188)×10-3mm2/s,宫颈癌ADC值为(0.865±0.184)×10-3mm2/s,两者差异有统计学意义(P<0.05)。宫颈癌病灶体积与ADC值无相关性(r=0.139,P=0.351);宫颈癌ADC值与病理分级有相关性(r=0.848,P=0.000)。结论 DWI对宫颈癌原发灶具有良好的对比度,可以清晰观察病灶形态、边缘。定量指标ADC值与病理分化程度存在相关性,可以用来提示肿瘤分化程度。临床分期低、ADC值高的病灶,预后会更好。

Objective To investigate the diagnostic value of diffusion weighted imaging（DWI）for cervical squamous cell carcinoma,analyze the correlation between ADC value and the grading of tumor.Methods Conventional and DWI（diffusion factor of 0.500and 1000s/mm2）were performed in fortyseven female patients with uterine cervix cancer with the lesions diameter greater than or equal to 3cm and twenty-three female patients with other gynecological diseases.The signal intensities of the lesions and normal uterine cervix were observed and the ADC values of them were measured.The relations of normal cervical tissues and cervical cancer were analyzed,while cervical cancer of the ADC and cervical cancer cell differentiation and the volume were compared.Results The ADC was statistically different between normal and cancerous tissue in the uterine cervix,the mean ADC of cervical cancer lesions was（0.865±0.184）×10-3 mm2/s,and that of normal cervix tissue was（1.416±0.188）×10-3 mm2/s（P0.05）.There was no correlation between the volume and the ADC of uterine cervix cancer（r=0.139,P=0.351）.And there was positive correlation between the ADC value of uterine cervix cancer and the grading of tumor（r=0.848,P=0.000）.Conclusions DWI can show the cervical cancer primary tumors with good contrast,and can clearly observe the lesion shape and margin.The ADC of tumor is correlated with the grading of tumor and can be used to prompt the tumor differentiation.The lower clinical stages and the higher ADC,the better prognosis will be.