IVIM-DWI多模型参数分析对宫颈癌的诊断价值

Diagnostic value of intravoxel incoherent motion DWI multiple models parameter analyses in cervical cancer

目的:探讨体素不相干运动扩散加权成像(IVIM-DWI)多模型参数分析对宫颈癌的诊断价值。方法:对经病理证实的、未经化放疗的29例宫颈癌患者(宫颈癌组)和23例宫颈正常患者(正常宫颈组)行11个b值的(0~1000s/mm2)IVIM-DWI扫描,分别测量宫颈癌组织和正常宫颈内膜组织的单指数模型、双指数模型及拉伸指数模型参数值,使用两独立样本t检验比较两组间各参数值的差异,采用受试者工作特征(ROC)曲线评价各参数值的预测值及诊断效能,采用Pearson双侧检验法分析宫颈癌组ADC_(stand)值与其他参数值间的相关性,P<0.05为差异有统计学意义。结果:宫颈癌组的ADC_(stand)、ADCslow、F_(fast)、DDC、α值明显低于正常宫颈组,ADC_(fast)高于正常宫颈组(P均<0.05)。宫颈癌组的Ⅱb期和Ⅲb期病例间各参数值差异均无统计学意义(P均>0.05)。宫颈癌组的ADCslow的ROC曲线下面积最大(0.986),DDC的ROC曲线下面积次之(0.97)。宫颈癌组的ADC_(stand)与ADCslow、DDC均呈正相关(r=0.898、0.629,P均<0.05)。结论:IVIM-DWI能够有效区分宫颈癌组织与正常宫颈组织,双指数模型参数ADCslow和拉伸指数模型参数DDC的诊断效能优于单指数模型参数ADC_(stand),对宫颈癌的诊断具有重要价值。

Objective：To investigate the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging（IVIM-DWI）with multiple models parameter analyses in cervical cancer.Methods：29cases of patients with pathologically confirmed cervical cancer without the radiotherapy and 23 cases of patients with normal cervix with uterus myoma underwent IVIM scan with 11bvalues（0~1000s/mm^2）.The parameter values of the monoexponential model,the biexponential model and the stretched-exponential model were calculated respectively in cervical cancer tissue and the normal cervical endometrial tissue,and compared using two independent sample t test.The prediction parameters and diagnostic efficiency were compared by drawing receiver operating characteristic curve（ROC）.The ADC_（stand） was correlated with the ADC_（slow）、ADC_（fast）、F_（fast）、DDC andαby using Pearson correlation analysis.P〈0.05 was considered to indicate a significant difference.Results：The ADC_（stand）、ADC_（slow）、F_（fast）、DDC andαof cervical cancer were significantly lower than those of normal cervix,the ADC_（fast）of cervical cancer was higher than that of normal cervix（P〈0.05）.Analysis revealed no statistically significant difference of all parameter values between the two stages（Ⅱb、Ⅲb）of cervical cancer（P〈0.05）.The largest areas under ROC curve was the cervical cancer ADC_（slow）（0.986）and the second was the cervical cancer DDC（0.97）.The ADC_（stand）of cervical cancer was positively correlated with ADC_（slow）and DDC（r=0.898,0.629,P〈0.05）.Conclusion：IVIM-DWI can be used to reflect the characteristics of the microenvironment of cervical cancer.Diagnostic efficiency of the ADC_（slow）and DDC was better than that of ADC_（stand）,ADC_（slow）and DDC have important value for the diagnosis of cervical cancer.