弥散加权成像在95例宫颈腺癌病理分级/分型及临床分期中的应用

Application of Diffusion Weighted Imaging in Pathological Grading/Typing and Clinical Staging of 95 Cases of Cervical Adenocarcinoma

目的探讨弥散加权成像(DWI)与宫颈腺癌病理分级/分型及临床分期的相关性。方法回顾性收集2011年5月至2018年2月在中国医学科学院肿瘤医院确诊为宫颈腺癌的患者95例,治疗前均行常规MRI及DWI检查,b值取0、800 s/mm^(2),测量宫颈腺癌的表观弥散系数(ADC)均值,比较ADC均值在宫颈腺癌不同分化程度、不同病理类型及不同临床分期中的差异。结果宫颈腺癌低分化组ADC均值为(1.00±0.25)×10^(-3) mm^(2)/s,中分化组ADC均值为(1.09±0.25)×10^(-3) mm^(2)/s,高分化组ADC均值为(1.22±0.20)×10^(-3) mm^(2)/s。低分化组与高分化组病灶ADC均值差异具有统计学意义(P=0.002)。子宫颈管腺癌(普通型)组ADC均值为(1.04±0.24)×10^(-3) mm^(2)/s,黏液腺癌组ADC均值为(1.21±0.26)×10^(-3) mm^(2)/s,两组病灶的ADC均值差异有统计学意义(P=0.005)。结论宫颈腺癌分化程度越差,ADC均值越低。黏液腺癌的ADC均值高于子宫颈管腺癌(普通型)。

Objective To investigate the correlations of diffusion weighted imaging(DWI)with pathological grading,typing and clinical staging of cervical adenocarcinoma.Methods The data of 95 patients with cervical adenocarcinoma from May 2011 to February 2018 in Cancer Hospital Chinese Academy of Medical Sciences were collected for retrospective analysis.Before treatment,conventional MRI and DWI(b=0,800 s/mm^(2))were performed,and the apparent diffusion coefficient(ADC)value of cervical adenocarcinoma was measured.The ADC values were compared among different pathological grades,types,and clinical stages.Results The mean ADC value was(1.00±0.25)×10^(-3) mm^(2)/s in the poorly differentiation group,(1.09±0.25)×10^(-3) mm^(2)/s in the moderately differentiation group,and(1.22±0.20)×10^(-3) mm^(2)/s in the well differentiation group,which showed significant difference between the poorly and well differentiation groups(P=0.002).The mean ADC values were(1.04±0.24)×10^(-3) mm^(2)/s and(1.21±0.26)×10^(-3) mm^(2)/s in the endocervical adenocarcinoma(usual type)group and mucinous carcinoma group,respectively,which showed significant difference(P=0.005).Conclusions The worse differentiation of cervical adenocarcinoma corresponded to the lower ADC value.The ADC value of mucinous carcinoma was higher than that of endocervical adenocarcinoma(usual type).