DWI在宫颈癌诊断中的应用及其与病理相关性研究

Application value of diffusion weighted image in diagnosing cervical carcinoma and its correlation with pathology

目的探讨弥散加权成像(DWI)在宫颈癌诊断中的应用及其与宫颈癌病理类型的相关性。方法收集该院2013-08~2015-01共88例病理确诊为宫颈癌的盆腔MRI资料,其中鳞癌84例、腺癌4例。鳞癌中Ⅰ级16例、Ⅱ级46例、Ⅲ级22例。同时收集88例非经期或绝经期健康女性的盆腔MRI资料,分别比较宫颈癌与正常宫颈ADC值及鳞癌与腺癌ADC值的差异,绘制ROC曲线并利用曲线下面积评价判断标准的价值;分析不同病理级别宫颈癌的ADC值并分析其相关性。结果宫颈癌ADC值(0.842±0.151)10^(-3)mm^2/s,低于正常宫颈(1.387±0.087)10^(-3)mm^2/s;且鳞癌ADC值(0.835±0.149)10^(-3)mm^2/s低于腺癌(0.999±0.083)10^(-3)mm^2/s,差异均有统计学意义(P<0.05)。同时ADC值对区分宫颈癌与正常宫颈,鳞癌与腺癌的ROC曲线下面积(AUC值)分别为0.991、0.908。Ⅰ、Ⅱ、Ⅲ级鳞癌的ADC值分别为(1.059±0.155)、(0.847±0.043)、(0.680±0.084)10^(-3)mm^2/s,且两两之间比较差异有统计学意义(P<0.05)。结论宫颈癌的弥散加权成像可以提供形态学以外的信息,不仅有助于诊断宫颈癌,还在一定程度上帮助评估其病理分型与分级,是对常规磁共振检查的一个有益补充。

Objective To explore the application value of diffusion weighted image in diagnosing cervical carcinoma and its correlation with pathology.Methods Of the 88 patients with cervical cancers,84 suffered from squamous cell carcinoma(gradeⅠin 16 cases,gradeⅡin 46 cases and gradeⅢin 22 cases),and 4 suffered from adenocarcinoma.Other 88 healthy women during non-menstrual or menopausal period were taken as the controls.The differences of ADC value were compared among cervical cancer,normal cervix,squamous cell carcinoma and adenocarcinoma,and the area under the ROC was simultaneously plotted to evaluate the diagnostic effect.The ADC values of different grades of cervical cancers and their correlation were analyzed.Results The ADC value of cervical cancer[(0.842±0.151)10-3 mm 2/s]was lower than that of normal cervix[(1.387±0.087)10-3 mm 2/s],and the ADC value of squamous cell carcinoma[(0.835±0.149)10-3 mm 2/s]was lower than that of adenocarcinoma[(0.999±0.083)10-3 mm 2/s]whose area under the ROC was 0.991 and 0.908 respectively.The ADC values of gradeⅠ,ⅡandⅢwere[(1.059±0.155),(0.847±0.043)and(0.680±0.084)10-3 mm 2/s]respectively.Conclusion DWI can provide more information than the morphology for diagnosing cervical carcinoma,and help to improve the pathological classification and grading.