宫颈癌的磁共振扩散加权成像特点初步研究

Diffusion-Weighted MR Imaging of Cervical Cancer

目的探讨宫颈癌的扩散加权成像特点,研究表观扩散系数(ADC)及相对表观扩散系数(rADC)在宫颈癌的鉴别诊断价值。方法对24例宫颈癌(高分化8例,中分化10例,低分化6例)和19例对照者行1.5TMRI检查并进行ADC值的测定(b值为800s/mm2)。闭孔内肌作参比部位,测量宫颈癌及正常宫颈的rADC值,进行统计学分析。结果宫颈癌平均ADC、rADC值分别为(1.04±0.21)×10-3mm2/s、0.81±0.23,显著低于正常宫颈组织。高分化宫颈癌ADC、rADC值((1.24±0.25)×10-3mm2/s、1.01±0.26)显著高于低分化((0.84±0.05)×10-3mm2/s、0.62±0.05)和中分化宫颈癌((1.01±0.06)×10-3mm2/s、0.75±0.12)。低分化和中分化宫颈癌ADC、rADC值无统计学差异。结论 ADC有潜力鉴别宫颈癌与正常宫颈结构,以闭孔内肌作参比部位,所获得的ADC、rADC值可以反映宫颈癌的扩散特征,有潜力反映宫颈癌的病理分级。

Objective To determine the feasibility of diffusion-weighted（DW） MRI of cervical cancer and to investigate whether the apparent diffusion coefficient（ADC） values and the relative apparent diffusion coefficient（rADC） of cervical cancer differ from those of normal cervix and whether they differ according to the histologic grade of the tumor（Internal obturator muscle as the reference site）.Methods Study population included 24 females with surgically proven cervical cancer and 19 females with pathologically confirmed normal cervix.ADC and rADC measurement were performed in cervical cancer and normal cervix with 1.5T MR（Internal obturator muscle as the reference site）,and compared the ADC and rADC value between two groups.Results All cervical cancer appeared hyperintense on DW images.The mean ADC value and the mean rADC value of cervical cancer was（1.04 ± 0.21）× 10-3mm2/s and（0.81 ± 0.23） respectively,which were significantly lower（P0.01） than those of normal cervix.The ADC and rADC values（（1.24± 0.25）× 10-3mm2/s and（1.01 ±0.26）） of highly differentiated group were significantly higher than those of moderately differentiated group（（1.01± 0.06）× 10-3mm2/s and（0.75 ± 0.12）） and lowly differentiated group（（0.84±0.05）×10-3mm2/s and（0.62±0.05））.There was no difference between the moderately differentiated group and lowerly differentiated group in ADC and rADC values.Conclusion The present study showed that DWI is feasible in demonstrating cervical cancer and ADC and rADC measurement（Internal obturator muscle as the reference site） has a potential ability to differentiate between normal and cancerous tissue of the cervix.