DWI联合DCE-MRI在宫颈癌诊断及分期、淋巴结转移评估中的应用价值

Application value of DWI combined with DCE-MRI in the diagnosis,staging and lymph node metastasis evaluation of cervical cancer

目的探究弥散加权成像(DWI)联合动态增强磁共振成像(DCE-MRI)在宫颈癌诊断及分期、淋巴结转移评估中的应用价值。方法选择2019年3月至2021年3月本院收治的76例宫颈癌患者为宫颈癌组,另选取同期40例非宫颈病变患者为对照组。所有患者均经磁共振成像(MRI)常规平扫、DWI、DCE-MRI扫描。比较MRI常规平扫与DWI联合DCE-MRI对宫颈癌的诊断价值。结果宫颈癌组的容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积分数(Ve)高于对照组(P<0.05)。宫颈癌组的宫颈癌组织表观弥散系数(ADC)值小于对照组的宫颈管内膜、结合带、肌层组织ADC值(P<0.05)。DWI联合DCE-MRI对宫颈癌Ⅰ、Ⅱ期的诊断符合率及转移型淋巴结的检出率高于MRI平扫(P<0.05)。转移型淋巴结的最小ADC值、平均ADC值小于非转移型淋巴结,长径(L)、短径(S)、S/L大于非转移型淋巴结(P<0.05)。结论常规MRI对宫颈癌的诊断价值有限,DWI联合DCE-MRI可提高宫颈癌术前诊断的准确性,值得临床推广与应用。

Objective To explore the application value of diffusion weighted imaging(DWI)combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis,staging and lymph node metastasis evaluation of cervical cancer.Methods A total of 76 patients with cervical cancer admitted in our hospital from March 2019 to March 2021 were selected as cervical cancer group,and 40 patients with non-cervical lesions were selected as control group.All patients underwent magnetic resonance imaging(MRI)conventional plain scan,DWI,and DCE-MRI scan.The diagnostic value of MRI conventional plain scan and DWI combined with DCE-MRI in cervical cancer were compared.Results The volume transfer constant(Ktrans),rate constant(Kep)and extravascular extracellular space volume fraction(Ve)in the cervical cancer group were higher than those in the control group(P<0.05).The apparent diffusion coefficient(ADC)value of cervical cancer tissue in the cervical cancer group was smaller than that of cervical endometrium,junctional zone and muscular layer tissues in the control group(P<0.05).The diagnostic coincidence rate of DWI combined with DCE-MRI for stageⅠandⅡcervical cancer and the detection rate of metastatic lymph nodes were higher than those of MRI plain scan(P<0.05).The minimum ADC value and average ADC value of metastatic lymph nodes were smaller than those of non-metastatic lymph nodes,and the long-axis diameter(L),short-axis diameter(S)and S/L were larger than those of non-metastatic lymph nodes(P<0.05).Conclusion The diagnostic value of conventional MRI for cervical cancer is limited.DWI combined with DCE-MRI can improve the accuracy of preoperative diagnosis of cervical cancer,which is worthy of promotion and application in clinic.