DWI在宫颈癌盆腔淋巴结转移诊断中的应用

The application of diffusion weighted imaging(DWI) in the diagnosis of lymph node metastases in patients with uterine cervical cancer

目的探讨扩散加权成像(DWI)在宫颈癌盆腔淋巴结转移诊断中的价值。方法收集经手术病理证实的宫颈癌36例,其中鳞癌32例,腺癌4例。全部病例均行常规MRI及DWI(b值取0、500、1000s/mm2)检查,分别测量盆腔转移淋巴结短轴径和ADC值,并进行统计学分析。结果 1)盆腔转移淋巴结DWI信号颇具特征性,呈现高信号或较高信号,ADC值为(1.071±0.220)×10-3 mm2/s;2)常规MRI和DWI检查对盆腔转移淋巴结的准确度、敏感性、特异性分别为82.0%、88.7%、81.3%和83.1%、94.3%、88.9%;3)淋巴结短轴径分别以5mm、7.5mm为阈值时,DWI诊断的敏感性、特异性及准确性分别为91.5%、58.3%、60.5%和81.2%、85.4%、81.9%。结论 DWI不受淋巴结大小影响,对盆腔短轴径小于10mm的转移性淋巴结的检出具有优势。

Objective To investigate the value of diffusion weighted imaging（DWI） in the diagnosis of lymph node metastases in patients with uterine cervical cancer.Methods Conventional and DWI（b value of 0、500 and 1 000 s/mm2） were performed in thirty-six female patients with uterine cervix cancer.All cases were confirmed by pathology,in which 32 cases were squamous cell carcinomas and four cases were adenocarcinomas.The apparent diffusion coefficient（ADC） and the short diameter were measured respectively for statistical analyzed.Results 1） The DWI signal of pelvic lymph node metastases was quite characteristic,showing a high signal or high signal,and the mean ADC value was（1.071±0.220） ×10-3mm2/s.2） The accuracy,sensitivity and specificity for conventional and DWI were 82.0%,88.7%,81.3% and 83.1%,94.3%,88.9%,respectively.3） The sensitivity,specificity and accuracy when the short diameter threshold was 5mm were 91.5%,58.3%,60.5% when it was 7.5mm,they were 81.2%,85.4%,81.9% respectively.Conclusions DWI is unrelated with the lymph node size,the advantages of detecting the lymph node metastases in the short diameter is less than 10mm.