3.0T磁共振成像体素内不相干运动相关参数对宫颈癌的诊断价值研究

Clinical study of the value of intravoxel incoherent motion parameters of 3.0T magnetic resonance imaging in the diagnosis of cervical cancer

目的观察3.0T磁共振成像(MRI)体素内不相干运动(IVIM)相关参数对宫颈癌的诊断价值。方法将68例宫颈癌患者设为观察组,按病理类型分为鳞状细胞癌组55例和腺癌组13例,另选取同期体检的46例健康女性设为对照组,所有研究对象均行常规MRI及IVIM扫描。比较3组患者标准表观扩散系数(ADCstand)、慢速表观扩散系数(ADCslow)、快速表观扩散系数(ADCfast)、快速扩散所占比例(Ffast)、分布扩散系数(DDC)、扩散异质性指数(α)值,分析宫颈鳞状细胞癌与宫颈腺癌患者上述IVIM相关参数变化情况,并观察上述参数对宫颈癌的诊断价值。结果3组患者ADCfast比较,差异无统计学意义(P﹥0.05)。鳞状细胞癌组及腺癌组患者ADCstand、ADCslow、DDC、Ffast、α值均低于对照组,鳞状细胞癌组患者ADCstand、ADCslow、DDC值均低于腺癌组,差异均有统计学意义(P﹤0.05);鳞状细胞癌组与腺癌组患者Ffast、α值比较,差异均无统计学意义(P﹥0.05)。经受试者工作特征(ROC)曲线处理,IVIM相关参数ADCstand、ADCslow、Ffast、DDC、α值诊断宫颈癌的曲线下面积分别为0.932、0.948、0.875、0.928、0.941。结论3.0TMRIIVIM参数能有效鉴别宫颈癌组织与正常宫颈组织,预判其病理类型。

Objective In order to observe the diagnostic value of intravoxel incoherent motion (IVIM) parameters of 3.0T magnetic resonance imaging (MRI) in the diagnosis of cervical cancer. Method A total of 68 cases of cervical cancer were included in the research as study group, and were subdivided as squamous cell carcinoma group with 55 cases and adenocarcinoma group with 13 cases, according to pathological types, during the same period, another 46 healthy women were enrolled as control group. All subjects underwent conventional MRI and IVIM scanning. The standard apparent diffusion coefficient (ADCstand), slow apparent diffusion coefficient (ADCslow), fast apparent diffusion coefficient (ADCfast), and fraction of fast ADC (Ffast), distributed diffusion coefficient (DDC) and the diffusion heterogeneity index (α) value were compared among the three groups, and the change of above IVIM-related parameters in cervical squamous cell carcinoma and cervical adenocarcinoma patients were analyzed, and their diagnostic value for cervical cancer were determined. Result There were no significant differences in ADCfast among the three groups (P>0.05). In squamous cell carcinoma and adenocarcinoma groups, the ADCstand, ADCslow, DDC, Ffast, and α value were lower compared to control group, and ADCstand, ADCslow, and DDC in squamous cell carcinoma group were lower than those in the adenocarcinoma group, showing statistically significant difference (P<0.05);though there was no significant difference regarding the Ffast and α value between squamous cell carcinoma group and adenocarcinoma group (P>0.05). The receiver operating characteristic (ROC) curve were plotted, which showed that the area under the curve (AUC) of IVIM-related parameters, including ADCstand, ADCslow, Ffast, DDC and α value, were 0.932, 0.948, 0.875, 0.928 and 0.941, respectively. Conclusion The IVIM parameters in 3.0T MRI can effectively help distinguish the cervical cancer tissues from normal cervical tissues and predict their pathological types in advance.