磁共振扩散加权成像对宫颈癌早期诊断和分期的价值

A study on the application of diffusion-weighted imaging in the diagnosis and staging of earlystage cervical cancer

目的探讨磁共振扩散加权成像(DWI)对宫颈癌早期诊断和分期的价值。方法选取32例宫颈病变患者,其中宫颈中分化癌14例,宫颈低分化癌9例,宫颈上皮内瘤变(CIN)9例,及健康志愿者31例,分别进行3.0 T磁共振DWI扫描;对正常对照组和不同分化类型的宫颈病变患者(宫颈CIN、中分化癌及低分化癌)间的ADC值进行统计学分析。结果正常对照组31例,病例组32例,宫颈浸润癌组23例,宫颈CIN组9例,宫颈中分化癌组14例,宫颈低分化癌组9例的ADC值平均值分别为(1.49±0.25)×10-3 mm2/s、(0.95±0.22)×10-3 mm2/s、(0.83±0.18)×10-3 mm2/s、(1.06±0.14)×10-3 mm2/s、(0.88±0.16)×10-3 mm2/s、(0.79±0.12)×10-3 mm2/s,病例组ADC值明显低于正常对照组,差异具有统计学意义(P<0.05);正常对照组、宫颈CIN组及宫颈浸润癌组的ADC值依次减低,且差异均有统计学意义(P<0.05);宫颈CIN组、宫颈中分化癌组及宫颈低分化癌组的ADC值依次减低,但只有低分化癌组与宫颈CIN组的差异有统计学意义(P<0.05)。结论病例组及浸润癌组ADC值明显低于正常对照组;宫颈CIN组、宫颈中分化癌组及宫颈低分化癌组的ADC值依次减低;DWI对宫颈癌早期诊断及恶性程度区分均有一定的价值。

Objcect To investigate the potential of the application of diffusion-weighted imaging（DWI）at 3.0 T magnetic resonance（MR）in diagnosing and staging of cervical cancer and cervical intraepithelial neoplasia（CIN）. Methods DWI scans were performed on 32 patients with cervical lesions, including 14 cases of moderately differentiated carcinoma, 9 cases of poorly differentiated carcinoma, 9 cases of cervical intraepithelial neoplasia（CIN）, and 31 healthy volunteers at 3.0 T. The ADC values were calculated for each case and compared between the patient group and the control groupas well asbetween groups with different differentiation types of cervical cancers（cervical CIN, moderately differentiated carcinoma and poorly differentiated carcinoma）. Result The mean ADC values of the control group, the patient group（all of the 32 cases withcervical lesions）, the invasive cervical cancer group, the CIN group, the moderately differentiated carcinoma group, and the poorly differentiated carcinoma group, were（1.49 ± 0.25）× 10^-3 mm^2/s、（0.95 ± 0.22）× 10^-3 mm^2/s、（0.83 ± 0.18）× 10^-3 mm^2/s、（1.06 ± 0.14）× 10^-3 mm^2/s、（0.88 ± 0.16）× 10^-3 mm^2/s and（0.79 ± 0.12）× 10^-3 mm^2/s. The mean ADC values in the group with cervical lesionsweresignificantly lower than the normal control group（P 0.05）. The mean ADC values of the normal control group ws significantly higher than that of the CIN group, which is in turn significantly higher than that of the invasive cervical cancer group（P 0.05）.The mean ADC values of the CIN group was slightly higher than that of the moderately differentiated carcinoma group, which was slightly higher than that of the poorly differentiated carcinoma; while only the difference between the mean ADC values of the CIN group and the poorly differentiated carcinoma group was significant（P 0.05）. Conclusion The mean ADC values of the cervical lesions group, the invasive cervical cancer were significantly lower than the normal control group. This study demonstrated the potential of DWI in diagnosis the early cervical cancer and distinction the degree of the cevical cancer.