MRI弥散加权成像与CT增强扫描对宫颈癌的诊断价值分析

Analysis of the Diagnostic Value of MRI Diffusion Weighted Imaging and CT Enhanced Scanning in Cervical Cancer

目的分析磁共振(MRI)弥散加权成像(DWI)与CT增强扫描在宫颈癌诊断中的应用价值。方法回顾性分析103例疑似宫颈癌患者的临床资料,均行CT增强扫描和DWI-MRI检查,以病理组织活检结果为“金标准”,比较DWI-MRI、CT增强扫描诊断结果、诊断效能(灵敏度、特异度、漏诊率、误诊率、准确度)、诊断预测值(阳性预测值、阴性预测值);并统计DWI-MRI确诊的符合病理结果的恶性、良性患者相关参数[流入速率(WIR)、流出速率(WOR)、最大相对增强率(MRE)、达峰时间(TTP)、扩散系数(ADC)]变化。结果103例疑似宫颈癌患者,经病理组织活检诊断出恶性87例,良性16例;DWI-MRI诊断恶性84例,良性13例;CT增强诊断恶性71例,良性10例。DWI-MRI检查灵敏度、准确度较CT增强扫描高,漏诊率较CT增强扫描低(P<0.05);DWI-MRI阴性预测值(81.25%)较CT增强扫描高(P<0.05);恶性宫颈癌患者WIR、WOR、MRE、ADC参数较良性患者高,TTP参数较良性患者低(P<0.05)。结论与CT增强扫描相比,DWI-MRI诊断宫颈癌灵敏度和准确度高,可降低漏诊率,且恶性和良性患者DWI-MRI参数存在较大差异,具有良好预测值,可为临床科学诊断提供依据。

Objective To analyze the application value of magnetic resonance imaging(MRI)diffusion weighted imaging(DWI)and CT enhanced scanning in the diagnosis of cervical cancer.Methods A retrospective analysis was conducted on the clinical data of 103 suspected cervical cancer patients.Both CT enhanced scans and DWI-MRI examinations were performed,with pathological tissue biopsy results as the"gold standard".The diagnostic results,diagnostic efficacy(sensitivity,specificity,missed diagnosis rate,misdiagnosis rate,accuracy),and diagnostic predictive value(positive predictive value,negative predictive value)were compared between DWI-MRI and CT enhanced scans;And statistically analyzed the changes in parameters related to malignant and benign patients diagnosed with DWI-MRI that comply with pathological results,such as inflow rate(WIR),outflow rate(WOR),maximum relative enhancement rate(MRE),time to peak(TTP),and diffusion coefficient(ADC).Results Among 103 suspected cervical cancer patients,87 were diagnosed as malignant and 16 as benign through pathological tissue biopsy;DWI-MRI diagnosed 84 malignant cases and 13 benign cases;CT enhanced diagnosis included 71 malignant cases and 10 benign cases.The sensitivity and accuracy of DWI-MRI examination were higher than those of CT enhanced scanning,and the missed diagnosis rate was lower than that of CT enhanced scanning(P<0.05);The negative predictive value of DWI-MRI was 81.25%higher than that of CT enhanced scan(P<0.05);Patients with malignant cervical cancer had higher WIR,WOR,MRE,and ADC parameters than benign patients,while TTP parameters were lower than benign patients(P<0.05).Conclusion Compared with CT enhanced scanning,DWI-MRI has higher sensitivity and accuracy in the diagnosis of cervical cancer,which can reduce the missed diagnosis rate.Moreover,there are significant differences in DWI-MRI parameters between malignant and benign patients,which have good predictive values and can provide a basis for clinical scientific diagnosis.