DWI联合MRI动态增强扫描在诊断宫颈癌分期中的应用

Application of DWI combined with dynamic contrast-enhanced MRI in diagnosis of cervical cancer staging

目的:分析DWI联合MRI动态增强扫描在宫颈癌国际妇产科联盟(FIGO)2018分期中的应用效果。方法:回顾性分析68例经病理证实的宫颈癌患者,均行DWI和动态增强扫描,分析DWI联合动态增强扫描与FIGO2018分期的诊断一致性。结果:68例中,FIGO2018分期ⅠB1期20例、ⅠB2期15例、ⅠB3期4例、ⅡA1期11例、ⅡA2期7例、ⅡB期2例、ⅢB期2例、ⅢC1期2例、ⅣA期5例;DWI联合动态增强扫描示55例与FIGO2018分期一致,其中,ⅠB1期18例、ⅠB2期13例、ⅠB3期2例、ⅡA1期9例、ⅡA2期5例、ⅡB期2例、ⅢB期1例、ⅢC1期1例、ⅣA期4例。经Kappa检验,2种诊断方法的一致性较好(K=0.768,P<0.05)。DWI联合动态增强扫描诊断宫颈癌ⅠB1、ⅠB2、ⅠB3、ⅡA1、ⅡA2、ⅡB、ⅢB、ⅢC1、ⅣA期的约登指数分别为0.879、0.848、0.469、0.801、0.665、0.985、0.470、0.485、0.784,准确率分别为95.59%、95.59%、94.12%、95.59%、92.65%、98.53%、95.59%、97.06%、97.06%。结论:DWI联合MRI动态增强扫描对宫颈癌的诊断与FIGO2018分期的一致性较好,诊断准确率较高。

Objective:To explore the application of DWI combined with dynamic contrast-enhanced MRI in FIGO 2018 staging for cervical cancer.Methods:The data of 68 patients with cervical cancer were retrospectively analyzed.They all underwent DWI and dynamic contrast-enhanced MRI.The consistency between DWI combined with dynamic contrast-enhanced scan diagnosis and FIGO 2018 staging was analyzed.Results:Among the 68 patients,20 cases were FIGO 2018 stageⅠB1,15 were stageⅠB2,4 were stageⅠB3,11 were stageⅡA1,7 were stageⅡA2,2 were stageⅡB,2 were stageⅢB,2 were stageⅢC1,and 5 were stageⅣA.DWI combined with dynamic contrast-enhanced scan were consistent with FIGO 2018 staging in 55 cases,18 cases of stageⅠB1,13 of stageⅠB2,2 of stageⅠB3,9 of stageⅡA1,5 of stageⅡA2,2 of stageⅡB,1 of stageⅢB,1 of stageⅢC1 and 4 of stageⅣA.And Kappa consistency test showed a good consistency between the two diagnostic methods(K=0.768,P<0.05).The Youden indices of DWI combined with dynamic contrast-enhanced scan in the diagnosis of cervical cancer at stagesⅠB1,ⅠB2,ⅠB3,ⅡA1,ⅡA2,ⅡB,ⅢB,ⅢC1 andⅣA were 0.879,0.848,0.469,0.801,0.665,0.985,0.470,0.485 and 0.784,respectively,and the accuracies were 95.59%,95.59%,94.12%,95.59%,92.65%,98.53%,95.59%,97.06%and 97.06%,respectively.Conclusions:DWI combined with dynamic contrast-enhanced MRI has a consistency with FIGO 2018 staging in diagnosis of cervical cancer,and has a high diagnostic accuracy.