T2WI序列联合小视野扩散加权成像对宫颈癌宫旁浸润的诊断价值

The Value of TWI Sequence Combined with Reduced Field of View Diffusion Weighted Imaging in the Diagnosis of Cervical Carcinoma Parametrial Invasion

目的探讨T2WI联合小视野扩散加权成像对宫颈癌宫旁浸润的诊断价值。方法回顾性搜集经临床手术病理证实为宫颈癌的83例患者。分析术前T2WI序列、常规视野扩散加权成像(cFOV-DWI)与小视野扩散加权成像(rFOV-DWI)的影像资料。由两位医师对不同序列进行图像质量评价并进行一致性检验。以术后病理结果为金标准,评价不同序列组合对宫颈癌宫旁浸润的准确性及临床应用价值。结果 rFOV-DWI的主观图像质量评分显著高于常规cFOV-DWI且差异具有统计学意义(P<0.01)。在FIGOⅠ期和Ⅲ期宫颈癌患者中,rFOV-DWI与cFOV-DWI对于宫旁浸润的诊断差异不具有统计学意义(P>0.05)。在FIGOⅡ期宫颈癌患者中,rFOV-DWI的诊断效能优于cFOV-DWI且差异具有统计学意义(P<0.05)。不同序列组合中,T2WI序列联合rFOV-DWI具有最优的诊断效能(P<0.05)。结论 rFOV-DWI比cFOV-DWI具有更好的图像质量,同时在FIGOⅡ期宫颈癌宫旁浸润判断中更具有诊断价值。T2WI联合rFOV-DWI对宫颈癌宫旁浸润具有较高的诊断价值,可以更好的指导临床诊疗。

Objective To investigate the value of T2WI sequence combined with reduced field of view diffusion weighted imaging in the diagnosis of cervical carcinoma parametial invasion. Methods 83 cases of cervical cancer confirmed by clinical operation and pathology were collected retrospectively.Preoperative T2WI sequences and imaging data of conventional field of view diffusion weighted imaging(cFOV-DWI) and reduced field of view diffusion weighted imaging(rFOV-DWI) were analyzed.The image quality of different sequences were evaluated by two physicians and the consistency test was carried out.Postoperative pathological results were used as the gold standard to evaluate the accuracy and clinical application value of different sequence in the parametial invasion of cervical cancer. Results The subjective image quality score of rFOV-DWI was significantly higher than cFOV-DWI and the difference was statistically significant(P<0.01).In stage of FIGO Ⅰ and Ⅲ cervical cancer, the diagnosis efficiency between FOV-DWI and cFOV-DWI have no statistically significant(P>0.05).But in stage of FIGO Ⅱ cervical cancer cases, the difference has statistically significant(P<0.05).Among different sequence combinations, T2WI sequence combined with rFOV-DWI has the optimal diagnostic performance(P<0.05). Conclusion rFOV-DWI not only have better image quality than cFOV-DWI,but have better diagnosis efficiency than cFOV-DWI in FIGO Ⅱ cervical cancer.T2WI combined with rFOV-DWI has a higher diagnostic value for cervical carcinoma parametial invasion, which can better guide clinical diagnosis and treatment.