RESOLVE-DWI对宫颈癌宫旁浸润的诊断价值

The Diagnostic Value of Resolve-DWI in Parauterine Infiltration of Cervical Cancer

目的探讨高清弥散(RESOLVE-DWI)加权成像在宫颈癌宫旁浸润诊断中的价值。方法收集65例经手术病理证实并分期的宫颈癌患者入组,所有患者均行高分辨T_(2)WI、常规DWI,RESOLVE-DWI检查。测量两组DWI图像的ADC值,并统计两组DWI内有宫旁浸润和无宫旁浸润组的ADC值有无统计学差异。由两位主治及以上医师使用双盲法对宫颈癌进行宫旁浸润的判定,将术前FIGO临床分期和多序列MRI分期的结果与手术病理结果对照,评价临床评估、HR-T_(2)WI+常规DWI、HR-T_(2)WI+RESOLVE-DWI三组方式对宫旁浸润评估的敏感度、特异度、阳性预测值、阴性预测值和准确性。将3组结果运用配对资料χ^(2)检验,比较四组宫旁浸润评估的准确度。用Kappa检验计算3组方法判断宫旁浸润与病理结果的一致性。结果常规DWI和RESOLVE-DWI两组ADC值的差异无明显统计学意义,两组内有宫旁浸润的ADC值均明显低于无宫旁浸润的组,差异有统计学意义。与临床评估相比,HR-T_(2)WI+DWI、HRT_(2)WI+RESOLVE-DWI均明显提高了宫旁浸润诊断的准确性,其中HR-T_(2)WI+RESOLVE-DWI诊断准确性最高,为宫颈癌治疗方案的选择提供了更科学合理的依据。

Objective To explore the diagnostic value of RESOLVE DWI for paracranial infiltration of cervical cancer.Methods A total of 65 patients with cervical cancer confirmed by surgery and pathology were enrolled,All patients underwent high resolution T_(2)WI,conventional DWI,RESOLVE-DWI examination.The ADC values of DWI images in the two groups were measured,and the ADC values of DWI groups with and without parafunctal infiltration were statistically different.The results of preoperative clinical evaluation and multi-sequence MRI evaluation were compared with the results of surgical pathology.The clinical stages of FIGO,HR-T_(2)WI+conventional DWI,HR-T_(2)WI+RESOLVE-DWI were evaluated.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the assessment were evaluated.Results three groups were compared with theχ^(2)test of paired data,and the accuracy of the evaluation of uterine invasion was compared between the three groups。Kappa test was used to calculate the consistency of 3 groups of methods to judge the infiltration of uterus and pathological results.Conclusion There was no significant difference in ADC values between the conventional DWI and RESOLVE-DWI groups,and the ADC values in the two groups with paraval infiltration were significantly lower than those in the group without paraval infiltration,and the difference was statistically significant.Compared with FIGO clinical stage,high-HR-T_(2)WI+conventional DWI,HR-T_(2)WI+RESOLVE-DWI can improve the accuracy of the diagnosis of parametrial invasion,and can provide more scientific and reasonable help for the choice of treatment options for cervical cancer.