多b值DWI与宫颈癌病理学特征的相关性研究

A correlative study between multi-b-value DWI and different pathological features in cervical cancer

目的:探讨多b值双指数模型扩散加权成像(DWI)与宫颈癌病理学特征的关系。方法:41例经手术病理证实的宫颈癌患者被纳入研究,包括宫颈鳞癌33例(高分化、中分化、低分化分别为6、20和7例),宫颈腺癌8例。所有患者均行3.0T MRI多b值DWI扫描(b=0、20、100、200、500、800、1200、1500s/mm2),采用双指数衰减模型计算慢速表观扩散系数(ADCslow)、快速表观扩散系数(ADCfast)、快速扩散所占容积分数(Ffast),比较这些参数在不同病理类型及分化程度宫颈癌中的差异。结果:宫颈鳞癌的ADCslow、ADCfast及Ffast分别为(0.39±0.14)×10-3 mm2/s、(52.31±26.11)×10-3 mm2/s、0.46±0.12,宫颈腺癌的ADCslow、ADCfast及Ffast分别为(0.73±0.13)×10-3 mm2/s、(18.05±11.13)×10-3 mm2/s、0.34±0.06,宫颈鳞癌和腺癌的ADCslow、ADCfast及Ffast差异均具有统计学意义(P均<0.05),宫颈高分化、中分化、低分化鳞癌ADCslow分别为(0.56±0.15)×10-3、(0.39±0.09)×10-3和(0.22±0.07)×10-3 mm2/s,两两间差异均具有统计学意义(P均<0.05)。结论:ADCslow、ADCfast及Ffast有助于鉴别宫颈鳞癌及腺癌,ADCslow值与宫颈鳞癌分化程度呈正相关。

Objective：To investigate the correlation between multi-b-value DWI based on bi-exponential signal decay model and pathological features of cervical cancer. Methods： 41 patients with pathologically confirmed cervical cancer were included in the study,including 33 squamous cell carcinoma （well, moderately and poorly differentiated were 6,20 and 7 re- spectively） and 8 adenomatous carcinoma. All patients underwent 3.0T MRI scan using multi-b-value DWI sequence （b= 0, 20,100,200,500,800, 1200, 1500s/mm2 ）. Apparent diffusion coefficient （ADCslow）, fast apparent diffusion coefficient （ADCfast） and fraction of ADCfast （Ffast） were recorded using bi-exponential signal decay model, which were then compared statistically between different pathological types and different differentiated subtypes. Results： ADCslow, ADCfast and Ffast of squamous cell carcinoma were （0.39±0. 14）×10-3mm2/s,（52. 31±26. 11） ×10-3mm2/s,and 0. 46..0. 12. ADCslow, ADCfast, and Ffast, of adenomatous cell carcinoma were （0.73±0.13）×10-3mm2/s,（18.05±1.13）×10-3mm2/s,0.34--0. 06. The differences above were statistically significant （P〈0.05）. ADCslow in well, moderately and poorly differentiated squamous cell carcinoma were （0.56±0.15）×10-3mm2/s,（0.39±0.09）×10-3mm2/s,and （0.22±0.07）X10 amm2/s respectively. ADCslow in any two groups was different significantly. Conclusion： ADCslow, ADCfast, and Ffast, are helpful in i- dentifying squamous cell cervical carcinoma from adenocarcinoma. ADCslow value of cervical squamous cell carcinoma is posi- tively correlated with the degree of differentiation.