初探DTI定量参数对子宫颈鳞状细胞癌和腺癌鉴别诊断的价值

A Preliminary Study on the Diagnostic Value of Diffusion Tensor Imaging Quantitative Parameters in Distinguishing Cervical Squamous Cell Carcinoma and Cervical Adenocarcinoma

目的:初探弥散张量成像(DTI)定量参数对子宫颈鳞状细胞癌(CSCC)和子宫颈腺癌(CAC)的鉴别价值。方法:回顾性分析经手术病理证实的20例CSCC和16例CAC的患者资料,所有患者均行1.5T MR检查。测量两组病灶实质区DTI的ADC值和各向异性分数(FA)值,采用两独立样本t检验比较两组病灶间各参数值的差异,采用ROC曲线评估各参数值鉴别两组病灶的效能,并找出相应界值。结果:两组ADC、FA值分别为:CSCC组(1.05±0.08)×10-3mm^2/s、0.17±0.02,CAC组(1.30±0.12)×10-3mm^2/s、0.23±0.04;CSCC组的ADC和FA值均小于CAC组,差异均具有统计学意义(P<0.001);ADC、FA值鉴别两组病灶的AUC分别为0.959、0.906,ADC值≥1.15×10-3mm^2/s,FA值≥0.19为预估CAC的界值,敏感度和特异度分别为87.5%和90.0%、81.3%和90.0%。结论:DTI可提供有效鉴别CSCC和CAC的定量参数,具有一定临床应用价值。

Purpose: This study was to evaluate the diagnostic value of diffusion tensor imaging (DTI) in distinguishing cervical squamous cell carcinoma (CSCC) and cervical adenocarcinoma (CAC). Methods: The DTI images of 20 patients with CSCC and 16 patients with CAC adenocarcinoma were analyzed retrospectively. The DTI parameters of two groups were measured, included apparent diffusion coefficient (ADC) and fractional anisotropy (FA). The independent samples t test was used to compare the parameters of two groups, the ROC curve was used to evaluate the effectiveness of each parameter and evaluate the boundary values. Results: The ADC and FA values of CSCC were (1.05±0.08)×10^-3mm^2/s and 0.17±0.02, respectively. The ADC and FA values of CAC were (1.30±0.12)×10^-3mm^2/s and 0.23±0.04, respectively. The ADC and FA values of CSCC were less than that of CAC (P<0.05). The areas under curve (AUC) of the ADC and FA values to diagnose CAC were 0.959 and 0.906, respectively. The boundary values to diagnose CAC were ADC ≥ 1.15×10^-3mm^2/s and FA ≥ 0.19, respectively. Sensitivity and specificity were 87.5% and 90.0%, 81.3% and 90.0%, respectively. Conclusion: DTI provides multiple quantitative parameters that can be used to effectively identify CSCC and CAC, which has some clinical application prospects.