MR扩散加权成像在宫颈癌不同病理类型中的应用价值

Application of MR diffusion-weighted imaging in different histological types of cervical carcinoma

目的:探讨磁共振扩散加权成像(diffusion-weighted imaging,DWI)在不同组织学类型宫颈癌诊断中的价值。方法:回顾性分析114例(鳞癌63例、腺癌30例、腺鳞癌21例)经手术病理证实的宫颈癌患者的DWI资料,测量表观扩散系数(apparent diffusion coefficient,ADC),比较各组ADC值的差异。分析宫颈癌ADC值与病理学参数Ki-67指数之间的相关性。结果:63例宫颈鳞癌、30例宫颈腺癌和21例宫颈腺鳞癌患者的平均ADC值分别为(0.861±0.112)×10-3 mm2/s、(0.846±0.18)×10-3 mm2/s和(0.796±0.124)×10-3 mm2/s,三组之间及两两比较的ADC值差异均无统计学意义(P=0.166)。12例宫颈黏液型腺癌患者的平均ADC值为(1.014±0.123)×10-3 mm2/s;18例非宫颈黏液腺癌患者的平均ADC值为(0.734±0.11)×10-3 mm2/s,两者之间及两者与宫颈鳞癌之间ADC值差异有统计学意义(P<0.001)。114例宫颈癌患者的ADC值与病理学参数Ki-67指数仅呈弱的负相关(r=-0.232,P=0.013)。结论:DWI有助于宫颈癌部分组织学类型的诊断。

Objective： To investigate the value of MR diffusion-weighted imaging（DWI） in the diagnosis of different histologic types of cervical carcinoma. Methods： The DWI data of 114 patients with cervical carcinoma（63 cases with squamous carcinoma, 30 with adenocarcinoma, 21 with adenosquamous carcinoma） proved by surgery and pathology were reviewed retrospectively. The apparent diffusion coefficient（ADC） values were measured, and the correlation between ADC value and pathological parameter Ki-67 was analyzed. Results： The mean ADC values of cervical squamous carcinoma, adenocarcinoma and adenosquamous carcinoma were（0.861±0.112）×10-3 mm2/s,（0.846±0.18）×10-3 mm2/s and（0.796±0.124）×10-3 mm2/s, respectively. Statistically significant difference was not found in overall and in multiple comparisons（P=0.166）. The mean ADC value in 12 patients with cervical mucinous adenocarcinomas was（1.014±0.123）×10-3 mm2/s, in 18 non-mucinous adenocarcinomas was（0.734±0.11）×10-3 mm2/s. There were statistically significant differences between the two groups, and between them and cervical squamous carcinoma（P〈0.001）. There was a weak negative correlation between mean ADC value and Ki-67 expression in 114 cases with cervical carcinoma（r=-0.232, P=0.013）. Conclusion： MR-DWI is a useful tool for differentiating some histological types of cervical carcinoma.