初诊宫颈癌磁共振平扫、DWI特征及与患者临床特征的相关性

Magnetic resonance scan, DWI features and correlation with clinical characteristics in the newly diagnosed cervical cancer

目的探讨初诊宫颈癌患者的磁共振(MR)平扫及扩散加权成像(DWI)特征,分析其诊断价值及与患者临床特征的关系。方法选择90例初诊宫颈癌患者为研究对象,所有患者均接受MR平扫及DWI检查,分析初诊宫颈癌患者的MR图像特征。比较不同国际妇产科联盟(FIGO)分期、病理类型及分化程度宫颈癌患者的表观弥散系数(ADC),分析ADC值与微血管密度(MVD)的相关性。结果 MR对宫颈癌分期的诊断准确率为94.4%。不同FIGO分期宫颈癌患者的ADC值比较,差异有统计学意义(F=4.350,P=0.016),且Ⅲ期宫颈癌患者的ADC值低于Ⅰ期和Ⅱ期患者(P<0.05)。不同病理类型宫颈癌患者的ADC值比较,差异有统计学意义(F=6.940,P=0.002),鳞癌患者的ADC值高于腺癌和腺鳞癌患者(P<0.05)。不同分化程度宫颈癌患者的ADC值及MVD比较,差异均有统计学意义(F=10.499、4.623,P<0.05),宫颈癌患者的ADC值与MVD呈负相关(r=-0.692,P=0.017)。结论宫颈癌患者的MR平扫及DWI具有典型特征,且ADC值与患者的临床特征存在密切关系,可用于术前评估。

Objective To investigate the features of MR plain scan and diffusion weighted imaging（DWI） of newly diagnosed cervical cancer patients, to analyze the diagnosis value and relationship with patients’ clinical features. Meth Method A total of 90 patients with newly diagnosed cervical cancer were selected, all patients underwent MR plain scan and DWI examination, the features of MR images were analyzed. The apparent diffusion coefficients（ADC） of cervical cancer patients with different FIGO staging, pathological type and degree of differentiation were measured and compared.The correlation between ADC value and microvessel density（MVD） was analyzed. Result The diagnostic accuracy of MR staging was 94.4%. There were significant differences in ADC values of cervical cancer patients at different FIGO stages（F=4.350, P=0.016）. The ADC value of stage Ⅲ cervical cancer was significantly lower than that of stage Ⅰ and Ⅱ,and the difference were statistically significant（P〈0.05）. There were significant differences in ADC values of cervical cancer patients with different pathological types（F=6.940, P=0.002）. The ADC value of patients with squamous cell carcinoma was higher than that of adenocarcinoma and adenosine squamous cell carcinoma, and the difference was statistically significant（P〈0.05）. The ADC value and MVD of cervical cancer patients with different degree of differentiation were statistically different（F=10.499、4.623, P〈0.05）. There was a negative correlation between ADC value and MVD value（r=-0.692, P=0.017）. Conclusion The characteristics of MR plain scan and DWI are typical in cervical cancer patients, and the ADC value is closely related to the clinical features, and can be used for preoperative evaluation.