不同b值联合诊断宫颈病变的价值

Value of different b-value combinations for the diagnosis of cervical lesions

目的探讨不同b值联合鉴别诊断宫颈良恶性病变及正常宫颈组织的价值。方法采用3.0T MR对106例宫颈癌、8例宫颈肌瘤、12例宫颈癌前期病变Ⅲ(CINⅢ)患者及67名正常对照者进行常规MR、DWI扫描,由b=0、600s/mm2及b=0、1000s/mm2两组ADC图计算ADC值,根据ROC曲线比较两组ADC图评估不同宫颈病变的价值。结果宫颈癌两组b值的ADC值均低于宫颈肌瘤、CINⅢ及正常宫颈组织(P均<0.001);宫颈肌瘤与CINⅢ、宫颈肌瘤与正常宫颈组织两组b值的ADC值差异均有统计学意义(P均<0.05);在CINⅢ与正常宫颈组织间两组b值的ADC值差异均无统计学意义(P均>0.05)。结论 ADC值对于鉴别宫颈恶性与良性病变及正常宫颈组织有较高价值;两组b值的诊断价值相当。

Objective To observe the value of different b-value combinations for the diagnosis of malignant and benign lesions or normal cervical tissues. Methods Totally 106 patients with cervical cancer, 8 with cervical leiomyoma, 12 with cervical intraepithelial neoplasia Ⅲ （CIN Ⅲ） and 67 normal controls underwent MR and DWI scan. All ADCs were calculated with b=0, 600 s/mm2 and b=0, 1000 s/mm^2. Results ADCs of cervical cancer were significantly lower than those of benign lesions or normal cervical tissues at both ADC maps （all P〈0. 001）, and statistical differences were found between cervical leiomyoma and CIN Ⅲ, as well as between leiomyoma and normal cervix at both ADC maps （all P〈0.05）. There was no significant difference between CIN Ⅲ and normal cervix at both ADC maps （both P〉0.05）. Conclusion ADC values are reliable in differentiating cervical malignancies from benign lesions or normal cervical tissue with high diagnostic accuracy. The diagnostic accuracy is equal at both ADC maps.