MRI扩散加权成像及其定量参数在宫颈癌的诊断和术前分期中的应用

Application of MRI Diffusion-weighted Imaging and Its Quantitative Parameters in the Diagnosis and Preoperative Staging of Cervical Cancer

目的探讨MRI扩散加权成像(DWI)及其定量参数平均表观扩散系数(mADC)、指数化表观扩散系数(eADC)在宫颈癌的诊断和术前分期中的应用。方法回顾性分析我院收治的67例宫颈癌患者与30例健康人群宫颈的mADC、eADC值的差异,评估两者的诊断效能。对照术后病理,评价常规MRI及常规MRI联合DWI对宫颈癌术前分期的诊断价值。结果宫颈癌的mADC值低于正常宫颈,e.ADC值则高于正常宫颈,且差异有统计学意义(P=0000);通过ROC曲线分.析,m.ADC、.eADC值诊断宫颈癌的AUC分别为096,098(P<00001.),两者差异无统计学意义,mADC值的最大YI为083,eADC值的最大YI为88,eADC值诊断宫颈癌的敏感度、特异度更高;常规MRI与常规MRI联合DWI对宫颈癌术前分期准确率差异无统计学意义(χ^(2)值=1.16,P>0.05),后者与病理结果符合率更高。结论eADC值对宫颈癌的诊断效能更佳;MRI常规序列联合DWI对宫颈癌术前分期具有较高的诊断价值。

Objective To investigate the application of MRI diffusion-weighted imaging(DWI)and its quantitative parameters mean apparent diffusion coefficient(mADC)and exponential apparent diffusion coefficient(eADC)in the diagnosis and preoperative staging of cervical cancer.Methods The differences of mADCand eADC values between 67 patients with cervical cancer and 30 healthy people admitted to our hospital were analyzed retrospectively,and the diagnostic efficacy of them was evaluated.Compared with postoperative pathology,the diagnostic value of conventional MRI and conventional MRI combined with DWI in preoperative staging of cervical cancer was evaluated.Results The mADC value of cervical cancer was lower than that of normal cervix,while the eADC value was higher than that of normal cervix,and the difference was statistically significant(P=0.000).According to ROC curve analysis,the AUC of mADC and eADC for cervical cancer diagnosis were 0.96 and 0.98(P<0.0001),there was no significant difference in the area under the curves(P>0.05).The maximum YI of mADC value was 0.83,and the maximum YI of eADC value was 0.88,indicating that eADC value had higher sensitivity and specificity in the diagnosis of cervical cancer.There was no significant difference in preoperative staging accuracy between conventional MRI and conventional MRI combined with DWI(χ^(2)=1.16,P>0.05),the latter had higher coincidence with pathological results.Conclusion eADC is more effective in the diagnosis of cervical cancer.Conventional MRI sequence combined with DWI has high diagnostic value in preoperative staging of cervical cancer.