T_(2)定量成像技术在宫颈癌临床分期与病理分化评估中的应用

Application of T_(2)mapping quantitative imaging in assessing clinical stage and pathological differentiation of cervical cancer

目的:探讨T_(2)定量成像(T_(2)mapping)技术在宫颈癌临床分期与病理分化评估中的应用价值。方法:收集107例经手术病理或宫颈活检证实的宫颈癌患者,术前行常规MRI、DWI和T_(2)mapping检查,分别测量肿瘤与正常子宫肌层的T_(2)值和ADC值。绘制ROC曲线,评价两者对宫颈癌临床分期和病理分化的诊断效能。结果:宫颈癌组织T_(2)值高于肌层非肿瘤组织,而ADC值则低于肌层非肿瘤组织(P<0.05);低分期宫颈癌组织T_(2)值和ADC值均高于高分期组织(P<0.05);低分化宫颈鳞癌组织T_(2)值和ADC值均低于中高分化组织(P<0.05)。T_(2)值和ADC值鉴别高、低分期宫颈癌的ROC曲线的AUC(95%CI)分别为0.840(0.756~0.904)、0.687(0.590~0.773),差异有统计学意义(P=0.025);T_(2)值和ADC值鉴别低、中高分化宫颈鳞癌的ROC曲线的AUC(95%CI)分别为0.770(0.632~0.875)、0.773(0.636~0.877),差异无统计学意义(P=0.970)。结论:T_(2)mapping技术对宫颈癌的临床分期及病理分化评估具有一定的应用价值,且T_(2)值对宫颈癌临床分期的诊断效能优于ADC值。

Aim:To investigate the value of T_(2)mapping quantitative imaging(T_(2)mapping)in assessing clinical stage and pathological differentiation of cervical cancer.Methods:Totally 107 patients with pathologically proven cervical cancer were collected.Routine MRI,DWI and T_(2)mapping were performed before treatment to measure T_(2)and ADC values of tumor and normal myometrium respectively.ROC curve was used to evaluate the diagnostic efficiency of T_(2)and ADC values.Results:T_(2)value was significantly higher in cervical cancer tissue than that in non-cancer tissue of muscular layer,while ADC value of cervical cancer tissue was significantly lower than that of non-cancer tissue of muscular layer(P<0.05).T_(2)and ADC values were significantly higher in low stage cervical cancer tissue than those in high stage tissue(P<0.05).T_(2)and ADC values were significantly lower in poorly differentiation cervical cancer tissue than those in moderately and highly differentiated tissue(P<0.05).The AUC(95%CI)of ROC curve of T_(2)and ADC values for distinguishing tumor stage were 0.840(0.756-0.904)and 0.687(0.590-0.773),respectively(P=0.025).The AUC(95%CI)of ROC curve of T_(2)and ADC values in differentiating poorly differentiation from moderately and highly differentiation were 0.770(0.632-0.875)and 0.773(0.636-0.877),respectively,with no significant difference(P=0.970).Conclusion:T_(2)mapping may be valuable in assessing clinical stage and pathological differentiation of cervical cancer.Moreover,the diagnostic efficiency of T_(2)value in differentiating clinical stage of cervical cancer is better than that of ADC.