初诊宫颈癌磁共振平扫、弥散加权成像特征及其与临床病理的相关性研究

Study on magnetic resonance imaging,DWI features of patients with newly diagnosed cervical cancer and the ;correlation with clinical pathological characteristics

目的：分析初诊宫颈癌磁共振平扫、弥散加权成像（DWI）特征，探讨其与临床病理特征的相关性。方法选取经病理确诊的100例初诊宫颈癌患者为研究对象，均接受磁共振平扫、DWI 检查，观察宫颈癌的磁共振特征，测量其 ADC 值及 MVD，比较不同分期宫颈癌的 ADC 值及 MVD，分析其相关性。结果病变信号特征为等长 T1、略长 T2信号，压脂序列呈明显高信号，与周边组织对比明显，DWI 序列呈高信号。在Ⅲ、Ⅳ期病变的诊断和分期中，磁共振均诊断正确，但磁共振将9例Ⅱ期病变误诊为Ⅰ期，将7例Ⅰ期病变误诊为Ⅱ期，与术后病理分期比较，其诊断准确率为84％。不同分期宫颈癌间 ADC 值[（0．917±0．055）s／mm2、（0．911±0．044）s／mm2、（0．887±0．047）s／mm2、（0．815±0．043）s／mm2]及 MVD[（27．38±5．66）、（29．54±7．32）、（34．46±8．92）、（35．26±8．84）]差异均有统计学意义（F ＝3．024、2．941，均 P ＜0.05），其中，Ⅲ、Ⅳ期宫颈癌 ADC 值显著低于Ⅰ、Ⅱ期宫颈癌，MVD 显著高于Ⅰ、Ⅱ期宫颈癌，差异均无统计学意义（t ＝2．992、2.976、3．954、3．689，均 P ＜0．05）。经 Pearson 相关分析，宫颈癌 ADC 值与 MVD 值间呈显著负相关（r ＝－0．678，P ＝0．021）。结论宫颈癌磁共振平扫及 DWI 图像具有特征性，与临床分期及 MVD 存在明显的相关性。

Objective To analyze the characteristics of magnetic resonance imaging（MRI）and DWI in newly diagnosed patients with cervical cancer,and to investigate the correlation between the clinical pathological features and the clinical pathological characteristics.Methods 100 cases of newly diagnosed cervical cancer were selected as the research subjects.All patients received magnetic resonance plain scan,DWI examination,MRI features of cervical carcinoma were observed,its ADC value and MVD were measured,ADC and MVD in different stages of cervical cancer were compared,its correlation was analyzed.Results The signal features of the lesions were as long as T2 , slightly longer T1 signal.The pressure sequence was obviously high signal.Compared with the surrounding tissue,DWI sequence was high signal.In the diagnosis and staging of Ⅲ and Ⅳstage lesion,the MRI diagnosis was right,MRI of the 9 cases of Ⅱstage lesion was misdiagnosed as Ⅰstage lesion,7 cases of Ⅰstage lesion were misdiagnosed as Ⅱstage lesion,compared with the postoperative pathologic staging,the diagnostic accuracy was 84%.There were signifi-cant differences in ADC value[（0.917 ±0.055）s/mm2 vs.（0.911 ±0.044）s/mm2 vs.（0.887 ±0.047）s/mm2 vs. （0.815 ±0.043）s/mm2 ]and MVD[（27.38 ±5.66）vs.（29.54 ±7.32）vs.（34.46 ±8.92）vs.（35.26 ±8.84）] between different stages of cervical cancer（F =3.024,2.941,all P 〈0.05）,The ADC value of cervical carcinoma inⅢ and Ⅳstage lesion was significantly lower than that of the Ⅰ and Ⅱstage lesion of cervical cancer,MVD was significantly higher than that of the Ⅰ and Ⅱstage lesion of cervical cancer,the differences were statistically signifi-cant（t =2.992,2.976,3.954,3.689,all P 〈0.05）.By Pearson correlation analysis,significantly negative correlation was found between ADC value and MVD value of cervical cancer（r =-0.678,P =0.021）.Conclusion The MRI and DWI images of cervical carcinoma are characteristic,there was a significant correlation between clinical stage andMVD.