弥散加权成像在宫颈癌淋巴结转移中的临床价值分析

Analysis of clinical value of diffusion-weighted imaging in cervical cancer lymph node metastasis

目的探讨弥散加权成像(DWI)在宫颈癌淋巴结转移中的诊断价值。方法选取2016年2月至2018年6月该院诊治的50例宫颈癌患者,共纳入287枚短径≥5 mm的淋巴结进行研究,根据其转移类型分为转移淋巴结组(n=49)与非转移淋巴结组(n=238),对所有患者进行核磁共振(MRI)和DWI检测,比较MRI检测下两组淋巴结的长径、短径、短径/长径水平。比较DWI检测下表观弥散系数最小值(ADC min)、表观弥散系数平均值(ADC mean)、淋巴结ADC min/癌灶ADC min之比(rADC min)和淋巴结ADC mean/癌灶ADC mean之比(rADC mean)。采用受试者工作特征曲线(ROC曲线)下面积(AUC)比较长径、短径、短径/长径、ADC min、ADC mean、rADC min和rADC mean对宫颈癌淋巴结转移的诊断价值。结果转移淋巴结组的长径、短径和短径/长径明显高于非转移淋巴结组(P<0.05);转移淋巴结组的ADC min、ADC mean、rADC min和rADC mean明显低于非转移淋巴结组;ADC min、ADC mean、rADC min和rADC mean的AUC值明显大于短径的AUC值(P<0.05)。结论DWI对宫颈癌淋巴结转移具有较高的诊断价值。

Objective To investigate the diagnostic value of diffusion weighted imaging(DWI)in cervical cancer lymph node metastasis.Methods A total of 50 patients with cervical cancer diagnosed and treated in this hospital from February 2016 to June 2018 were selected.A total of 287 lymph nodes with a short diameter of≥5 mm were included in the study.They were divided into metastatic lymph node groups(n=49)and non-metastatic lymph node group(n=238),all patients were examined by MRI and DWI,and the long,short,and short/long diameter levels of the two groups of lymph nodes were compared under MRI.The minimum diffusion coefficient(ADC min),the average apparent diffusion coefficient(ADC mean),the lymph node ADC min/cancer focus ADC min ratio(rADC min),and the lymph node ADC mean/cancer focus ADC mean ratio(rADC mean)were compared under DWI.The diagnostic value of long diameter,short diameter,short diameter/long diameter,ADC min,ADC mean,rADC min,and rADC mean in cervical cancer lymph node metastasis were compared by the area under the ROC curve(AUC).Results The long diameter,short diameter,and short diameter/long diameter of the metastatic lymph node group were significantly higher than those of the non-metastatic lymph node group(P<0.05);ADC min,ADC mean,rADC min,and rADC mean of the metastatic lymph node group were significantly lower than those of the non-metastatic lymph node group;the AUC values of ADC min,ADC mean,rADC min,and rADC mean were significantly greater than the short-path AUC values(P<0.05).Conclusion DWI has higher diagnostic value for cervical cancer lymph node metastasis.