MRI扩散加权成像表观扩散系数值在宫颈癌诊断中的应用

MRI Diffusion-weighted Imaging and Apparent Diffusion Coefficient Value in Application of Diagnosis of Cervical Cancer

目的探讨3.0 T MRI扩散加权成像(DWI)表观扩散系数(ADC)值在宫颈癌诊断中的应用价值。方法选取2018年2月—2021年2月诊治的25例宫颈癌为研究组,选取同期进行检查的未合并宫颈病变正常健康女性20例为对照组,所有研究对象均接受常规MRI及DWI检查。比较对照组宫颈组织与研究组病灶组织ADC值差异,以及不同病理分化程度宫颈癌病灶组织ADC值差异。分析ADC值与不同宫颈癌病理分化程度的相关性。比较正常宫颈三层结构间的ADC值差异,以及研究组非转移与转移淋巴结的ADC值差异。比较单纯T2WI检查及T2WI联合DWI检查对宫颈癌的检出率。结果研究组病灶组织的ADC值显著低于对照组宫颈组织(P<0.01)。不同病理分化程度的宫颈癌病灶组织ADC值比较差异有统计学意义(P<0.01)。ADC值与宫颈癌病理分化程度呈显著正相关性(r=1.251,P=0.001)。正常宫颈三层结构间ADC值比较差异无统计学意义(P>0.05)。研究组非转移淋巴结的ADC值显著高于转移淋巴结(P<0.01)。单纯T2WI检查与T2WI联合DWI检查对宫颈癌的检出率比较差异无统计学意义(P>0.05)。结论DWI检查能够对宫颈癌病灶的范围及位置进行清晰的观察,还能够通过测量ADC值对正常宫颈与宫颈癌进行有效的鉴别及区分。

Objective To investigate the value of 3.0 T magnetic resonance imaging(MRI)diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in application of diagnosis of cervical cancer.Methods A total of 25 patients with cervical cancer who had been diagnosed and treated between February 2018 and February 2021 were selected as research group,and 20 normal healthy women without cervical lesions who had undergone physical examination at the same period were selected as control group.All the research subjects received conventional MRI and DWI examinations.Differences in ADC values between cervical tissues in control group with lesion tissues in research group,as well as differences in ADC values in lesion tissues of cervical cancer with different degrees of pathological differentiation were compared.Correlations between ADC value with different degrees of pathological differentiation of cervical cancer were analyzed.Differences in ADC values among the three-layer structure of normal cervix and the difference in ADC value between patients with non-metastatic and metastatic lymph nodes in research group were compared.The detection rates of cervical cancer by T2 WI alone and T2 WI combined with DWI were compared.Results The ADC value of lesion tissue in research group was significantly lower than that of cervical tissue in control group(P<0.01).There were statistically significant difference in ADC values among lesions with different degrees of pathological differentiation of cervical cancer(P<0.01).There was a significant positive correlation between ADC value with degree of cervical cancer pathological differentiation(r=1.251,P=0.001).There were no significant differences in ADC values among the three-layer structure of normal cervix(P>0.05).The ADC values of patients with non-metastatic lymph nodes were significantly higher than those of patients with metastatic lymph nodes in research group(P<0.01).There was no significant difference in detection rate of cervical cancer between T2 WI alone with T2 WI combined with DWI(P>0.05).Conclusion DWI examination may enable clear observation of the scope and location of cervical cancer lesions,and it may also effectively identify and differentiate normal cervix from cervical cancer by measuring ADC value.