DWI联合DCE-MRI对宫颈神经内分泌癌的鉴别诊断价值

Value of DWI and Dynamic Contrast-Enhanced MRI in Differentially Diagnosing Neuroendocrine Carcinoma of the Uterine Cervix

目的探讨扩散加权成像(DWI)及动态增强(DCE)MRI对宫颈神经内分泌癌与宫颈鳞癌、腺癌的鉴别诊断价值。方法回顾性分析经病理证实的12例宫颈神经内分泌癌、39例宫颈鳞癌和21例宫颈腺癌患者的MRI平扫、DWI及DCE数据,分析其信号特点,计算ADC值、达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分别比较宫颈神经内分泌癌与另两种肿瘤间的差异。结果 12例宫颈神经内分泌癌中,T_1WI上3例呈等信号,9例呈低信号;T_2WI上10例呈高信号,2例呈等信号。DWI上均扩散受限呈高信号。宫颈神经内分泌癌的平均ADC值为(0.66±0.11)×10^(-3)mm^2/s,TTP为(94.53±33.35)s,EP为659.47±283.22,MCER为(225.41±70.67)%。宫颈神经内分泌癌的ADC值、TTP、EP与宫颈鳞癌、腺癌均有统计学差异,MCER值无统计学差异。结论宫颈神经内分泌癌的DWI及DCE-MRI表现有一定的特征,其ADC值、TTP、EP可作为有效量化指标用于与宫颈鳞癌及腺癌的鉴别。

Objective To assess the value of diffusion weighted imaging（ DWI） and dynamic contrast-enhanced（ DCE）MRI in differential diagnosis of neuroendocrine carcinoma of the uterine cervix（ NECUC）,squamous carcinoma of the cervix（ SCC） and adenocarcinoma of the uterine cervix（ AUC）. Methods A total of 12 NECUC,39 SCC and 21 AUC confirmed by pathology were analyzed retrospectively. All of the patients underwent DWI and DCE-MRI. The ADC value,TTP,EP and MCER were measured and compared between NECUC,SCC and AUC. Results In 12 NECUC,T1WI showed low signal in 9 cases and equal signal in 3 cases; T2WI images showed high signal in 10 cases and equal signal in 2 cases. On DWI,all cases showed diffusion restricted. The mean ADC value,TTP,EP and MCER of NECUC were（ 0. 66± 0. 11） × 10^- 3mm^2/ s,（ 94. 53 ± 33. 35） s,659. 47 ± 283. 22 and（ 225. 41 ± 70. 67） %. The differences of the mean ADC value,TTP and EP between NECUC,SCC and AUC were statistically significant. The differences of MCER between the tumors were not statistically significant. Conclusion DWI and DCE features of NECUC are characteristic,The differences of the mean ADC value,TTP and EP are helpful in the differential diagnosis of NECUC,SCC and AUC.