磁共振T_(2)mapping、T_(2)^(*)mapping成像评估宫颈癌的病理学特征

Quantitative Analysis of T_(2)Mapping and T_(2)^(*)Mapping in Evaluating Pathological Features of Cervical Cancer

目的对比T_(2)mapping、T_(2)^(*)mapping成像在鉴别宫颈癌类型、分化程度、预测淋巴血管间隙浸润(LVSl)的价值。方法对51例经病理证实的宫颈癌患者于治疗前行常规MR、T_(2)mapping和T_(2)^(*)mapping检查,测量肿瘤和正常子宫肌层的T_(2)值和T_(2)^(*)值。对比测量参数在肿瘤与正常子宫肌层、鳞癌与腺癌、高分化、中分化与低分化、LVSI阳性与LVSI阴性之间的差别,绘制ROC曲线,评价诊断效能。结果宫颈癌肿瘤与正常子宫肌层之间T_(2)值、T_(2)^(*)值差异均有统计学意义(P值均<0.001),鳞癌与腺癌之间T_(2)值、T_(2)^(*)值差异均无统计学意义(P值均>0.05),低分化组T_(2)值和T_(2)^(*)值均低于中分化组和高分化组(P值均<0.05),中分化组和高分化组之间T_(2)值、T_(2)^(*)值差异均无统计学意义(P值均>0.05)。LVSI阳性组T_(2)值和T_(2)^(*)值均明显低于LVSI阴性组(P均<0.05)。T_(2)值、T_(2)^(*)值对于鉴别低分化与中分化、低分化与高分化的ROC曲线下面积分别为0.714、0.727,0.787、0.733。T_(2)值、T_(2)^(*)值预测宫颈癌LVSI的ROC曲线下面积分别为0.650、0.702。结论T_(2)mapping和T_(2)^(*)mapping成像对宫颈癌分化程度的判断具有一定的提示作用,并有潜力应用于宫颈癌LVSI状态的预测。

Objective To explore the potential clinical value of T_(2)and T_(2)^(*)mapping technique in the evaluation of pathological type,tumor grade and lymphovascular space invasion(LVSI)of cervical cancer.Methods Totally 51 patients with pathologically proven cervical cancer underwent conventional MRI,T_(2)and T_(2)^(*)mapping before therapy.T_(2)and T_(2)^(*)values were obtained and compared between tumor and normal tissue(myometrium),squamous cell carcinomas and adenocarcinomas,well、moderately differentiated tumor and poorly differentiated tumor,LVSI-positive and LVSI-negative cervical cancer,respectively.ROC curve was constructed to evaluate diagnostic performances.Results T_(2)and T_(2)^(*)values showed significant differences between cervical cancer and normal tissue(both P<0.001).No significant difference was observed in T_(2)and T_(2)^(*)values between squamous cell carcinomas and adenocarcinomas(both P>0.05).Compared to well and moderately differentiated tumors,poorly differentiated tumors showed decreased T_(2)and T_(2)^(*)values(both P<0.05).There was no significant difference in T_(2)value and T_(2)^(*)value between to well and moderately differentiated tumors(P>0.05).T_(2)and T_(2)^(*)values were significantly lower in LVSI-positive than in LVSI-negative cervical cancer(both P<0.05).The AUC of T_(2)and T_(2)^(*)values for distinguishing poorly differentiated tumors from well and moderately differentiated tumors were O.714.0.727 and 0.787,0.733 respectively.The AUC of T_(2)and T_(2)^(*)value in discriminating the presence of LVS1 was were 0.650and 0.702,respectively.Conclusion Quantitative T_(2)and T_(2)^(*)mapping can putatively differentiate the grade of cervical cancer,and have the potential to predict the LVSI status of cervical cancer.