MR扩散加权成像在宫颈癌不同病理类型中的应用价值

The application of MR difusion-weighted imaging in diferent histological types of cervical carcinoma

目的探讨磁共振扩散加权成像（MR diffusion-weighted imaging,MR-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（ADC）值,比较各组间ADC值的差异.分析宫颈癌ADC值与病理学参数Ki-67的相关性.结果：63例宫颈鳞癌、30例宫颈腺癌和21例宫颈腺鳞癌的平均ADC值分别为（0.861±0.112）×10^-3 mm^2/s、（0.846±0.18）×10^-3 mm^2/s和（0.796±0.124）×10^-3 mm^2/s,三组间及两两比较的ADC值差异均无统计学意义（P=0.166）.12例宫颈黏液型腺癌的平均ADC值为（1.014±0.123）×10^-3 mm^2/s;18例非宫颈黏液腺癌的平均ADC值为（0.734±0.11）×10^-3 mm^2/s,两组间及它们与宫颈鳞癌间的ADC值差异均有统计学意义（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,相关系数为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 （MR-DWI） in the diagnosis of different histologic types of cervical carcinoma. Methods： The DWI data of 114 patients with cervical carcinomas （63 cases with squamous carcinoma, 30 with adenocarcinoma, 21 with adenosquamous carcinoma） proved by surgery and pathology were reviewed retrospectively. The apparent difusion coefcient （ADC） value was 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 mm^2/s, （0.846±0.18）×10^-3 mm^2/s and （0.796±0.124）×10^-3 mm^2/s. Statistically signifcant diference was not found in overall and in multiple comparisons （P=0.166）. The mean ADC value in twelve patients with cervical mucinous adenocarcinomas was （1.014±0.123）×10^-3 mm^2/s, in 18 non-mucinous adenocarcinomas was （0.734±0.11）×10^-3 mm^2/s. There was a statistically signifcant diference between the two groups, and between them and cervical squamous carcinoma （P〈0.001）. There was a weak negative correlation between the mean ADC value and the expression of Ki-67 in 114 cases with cervical carcinoma （r=-0.232, P=0.013）. Conclusion： DWI was a useful tool for diferentiating some histological types of cervical carcinoma.