多模态MRI分级影像报告对宫颈癌病情分期及分级的诊断

Diagnostic value of multimodal MRI graded imaging reports for the staging and grading of cervical cancer

目的研究多模态磁共振(MRI)分级影像报告对宫颈癌病情分期及分级的诊断价值。方法选取秦皇岛市第二医院于2019年1月到2020年10月收治的55例宫颈癌患者作为病例组,另选30例正常宫颈组织者作为正常组,均行盆腔常规MRI平扫、体素内不相干运动扩散加权磁共振(IVIM-DWI)、磁共振动态增强(DCE-MRI)扫描,分析MRI图像特征,比较不同病理分级、病情分期患者的IVIM-DWI参数[表观扩散系数(ADC)]和DCE-MRI参数[容积转运常数(K_(trans))、速率常数(K_(ep))],利用ROC曲线分析MRI各参数对不同病理分级、病情分期宫颈癌的诊断价值。结果病例组的ADC值低于正常组,K_(trans)、K_(ep)值均高于正常组(P<0.05);早期组的ADC值高于晚期组,K_(trans)值、K_(ep)值均低于晚期组(P<0.05);高分化组的ADC值高于中、低分化组,K_(trans)值低于中、低分化组(P<0.05);ADC值、K_(trans)值、K_(ep)值联合鉴别早、晚期宫颈癌的AUC为0.973(95%CI:0.912-0.996),且联合鉴别AUC高于单一鉴别(P<0.05);ADC值、K_(trans)值联合鉴别高、中低级宫颈癌的AUC为0.917(95%CI:0.811-0.974),且联合鉴别AUC高于单一鉴别(P<0.05)。结论多模态MRI分级影像报告对宫颈癌分期、分级的诊断具有重要价值。

Objective To study the diagnostic value of multimodal magnetic resonance imaging(MRI)graded imaging reports for the staging and grading of cervical cancer.Methods A total of 55 patients with cervical cancer admitted to the Qinhuangdao Second Hospital from January 2019 to October 2020 were enrolled as case group,while another 30 controls with normal cervical tissues were enrolled as normal group.All underwent routine pelvic MRI plain scan,intravoxel incoherent motion diffusion weighted MR Imaging(IVIM-DWI)and dynamic contrast enhanced MRI(DCE-MRI)scan.The characteristics of MRI images were analyzed.IVIM-DWI parameter[apparent diffusion coefficient(ADC)]and DCE-MRI parameters[volume transfer constant(K_(trans)),rate constant(K_(ep))]in patients with different pathological grades and disease stages were compared.The diagnostic value of MRI parameters for cervical cancer of different pathological grades and stages was analyzed by ROC curves.Results ADC in case group was lower than that in normal group,while K_(trans) and K_(ep) were higher than those in normal group(P<0.05).ADC value in early group was higher than that in advanced group,while K_(trans) and K_(ep) were lower than those in advanced group(P<0.05).ADC in high differentiation group was higher than that in moderate and poor differentiation groups,while K_(trans) value was lower than that in moderate and poor differentiation groups(P<0.05).AUC of ADC combined with K_(trans) and K_(ep) for identifying early and advanced cervical cancer was 0.973(95%CI:0.912-0.996),which was higher than that of single index(P<0.05).AUC of ADC combined with K_(trans) for identifying high-level,moderate-level and low-level cervical cancer was 0.917(95%CI:0.811-0.974),which was higher than that of single index(P<0.05).Conclusion Multimodal MRI graded imaging reports are of important diagnostic value for the staging and grading of cervical cancer.