宫颈癌3.0T MR表观弥散系数与动态增强半定量参数的相关性研究

Correlation between apparent diffusion coefficient and semi-quantitative parameters of dynamic contrast enhanced MR in cervical carcinoma at 3.0T MR

目的探讨宫颈癌诊断中动态增强MRI(DCE-MRI)半定量参数与DWI ADC值之间的相关性。方法对35例病理学证实的宫颈癌在术前行DCE-MRI和DWI,其中11例接受了术前同步放化疗且分别在放化疗前后行DCE-MRI和DWI。计算癌灶和正常宫颈的DCE-MRI半定量参数(最大相对增强率MRE、流入速率WIR、流出速率WOR、达峰时间TTP)和表观弥散系数(ADC),分析两者之间的相关性。结果宫颈癌的MRE、WIR、WOR、TTP和ADC分别为(163.01±25.56)%、81.32±17.16、15.26±3.99、(70.28±13.9)s和(0.860±0.081)×10-3 mm2/s,而正常宮颈依次为(145.56±32.67)%、70.61±19.57、13.47±5.21、(102.52±16.78)s和(0.671±0.092)×10-3 mm2/s。放化疗后宮颈癌灶的MRE、WIR和WOR减少,而TTP和ADC增加。无论放化疗前还是放化疗后,宫颈癌灶的ADC与MRE和WIR呈负相关、与WOR不相关、与TTP呈正相关。结论宫颈癌DCE-MRI半定量参数与DWI ADC值之间存在相关性。

Objective To explore the correlation between apparent diffusion coefficient（ADC）and semi-quantitative parameters of dynamic contrast enhanced MR（DCE-MRI）in cervical carcinoma.Methods Thirty five patients with pathology-proved cervical carcinoma were enrolled in this study.Among the 35 patients,24received diffusion-weighted imaging（DWI）and DCE-MRI before radical resection,11 underwent preoperative concurrent chemoradiotherapy and were performed DWI and DCE-MRI both before and after the chemoradiotherapy.The time-to-intensity curve of cancerous and non-cancerous region in the uterine cervix were obtained.Several semi-quantitative parameters including maximum relative enhancement（MRE）,wash in rate（WIR）,wash out rate（WOR）and time to peak（TTP）on DCE-MRI as well as the ADC value on DWI were calculated.Additionally,correlations between ADC value and each semi-quantitative parameter of the cervical carcinoma lesion were evaluated.Results The value of MRE,WIR,WOR,TTP and ADC in the cancerous region in the uterine cervix was（163.01±25.56）%,81.32±17.16,15.26±3.99,（70.28±13.9）s and（0.860±0.081）×10^-3 mm^2/s,respectively.However,in the non-cancerous region,the value of MRE,WIR,WOR,TTP and ADC was（145.56±32.67）%,70.61±19.57,13.47±5.21,（102.52±16.78）s and（0.671±0.092）×10^-3 mm^2/s respectively.After concurrent chemoradiotherapy,the MRE,WIR and WOR value of the cervical carcinoma decreased,whereas the TTP and ADC value increased.Both before and after the chemoradiotherapy,there were significant positive correlations between ADC and MRE or WIR as well as significant negative correlations between ADC and TTP in the cervical carcinoma.No significant correlation was found between ADC and WOR in the cervical carcer.Conclusion There are significant correlations between ADC and some semi-quantitative parameters of DCE-MRI in cervical carcinoma,which is potentially helpful for the diagnosis and therapy of cervical carcinoma.