摘要
目的:对比分析酰胺质子转移成像(APT)与扩散加权成像(DWI)在诊断宫颈鳞癌并评估其分级中的价值。方法:回顾性分析50例宫颈癌患者的临床及APT、DWI资料,根据病理类型分为腺癌组(n=11)与鳞癌组(n=39),并根据病理分级将鳞癌组分为低分化组(n=12)与高中分化组(n=27),测量宫颈癌组织的不对称性磁化转移率(MTR asym)、平均ADC值、最小ADC值,分别比较宫颈腺癌组与鳞癌组、宫颈鳞癌高中分化组与低分化组各参数值的差异,采用ROC曲线评价各参数值的诊断效能及最佳诊断阈值,并根据约登指数确定各参数相应的诊断敏感度、特异度。结果:宫颈鳞癌组MTR asym[(3.03±0.06)%]低于宫颈腺癌组[(3.12±0.05)%],平均ADC值、最小ADC值[(0.94±0.03)×10^-3 mm^2/s、(0.85±0.03)×10^-3 mm^2/s]低于宫颈腺癌组[(0.98±0.03)×10^-3 mm^2/s、(0.88±0.03)×10^-3 mm^2/s],差异均具有统计学意义(t=4.35、3.66、3.55,P值均<0.05);低分化宫颈鳞癌组MTR asym值[(3.08±0.03)%]高于高中分化鳞癌组[(3.00±0.05)%],平均ADC值、最小ADC值[(0.92±0.02)×10^-3 mm^2/s、(0.82±0.02)×10^-3 mm^2/s]低于高中分化鳞癌组[(0.95±0.03)×10^-3 mm^2/s、(0.86±0.02)×10^-3 mm^2/s],差异均具有统计学意义(t=5.37、2.55、4.08,P值均<0.05);在诊断宫颈鳞癌及低分化宫颈鳞癌时,MTR asym均有最佳诊断效能,ROC曲线下面积分别为0.865、0.932,以MTR asym=3.08%、3.06%为阈值,诊断敏感度分别为79.5%、85.2%,特异度分别为81.8%、83.3%。结论:与DWI相比,APT在诊断宫颈鳞癌并评估宫颈鳞癌分级中更具优势。
Objective:To compare the value of amide proton transfer imaging(APT)and diffusion-weighted imaging(DWI)in the diagnosis of cervical squamous cell carcinoma and evaluation of its histological grading.Methods:The clinical data of 50 patients with cervical cancer were recorded,and APT and DWI images were retrospectively analyzed.The patients were divided into adenocarcinoma group(n=11)and squamous cell carcinoma group(n=39)based on pathological types,and patients with squamous cell carcinoma were further divided into poorly differentiated group(n=12)and well/moderately differentiated group(n=27)according to the pathological grades.Asymmetric magnetization transfer rate(MTR asym),mean and minimum ADC values were measured and compared.The diagnostic efficiency and optimal diagnostic threshold of each parameter were evaluated by ROC curve,and the corresponding diagnostic sensitivity and specificity of each parameter were determined according to the Youden index.Results:Compare with adenocarcinoma,the MTR asym,and mean and minimum ADC values of the cervical squamous cell carcinoma were significant lower[(3.03±0.06)%vs(3.12±0.05)%;(0.94±0.03)×10^-3 mm^2/s vs(0.98±0.03)×10^-3 mm^2/s;(0.85±0.03)×10^-3 mm^2/s vs(0.88±0.03)×10^-3 mm^2/s].The MTR asym of poorly differentiated group was significant higher than that of well/moderately differentiated group[(3.08±0.03)%vs(3.00±0.05)%],but the mean and minimum ADC values of poorly differentiated squamous cell carcinoma were significant lower[(0.92±0.02)×10^-3 mm^2/s vs(0.95±0.03)×10^-3 mm^2/s;(0.82±0.02)×10^-3 mm^2/s vs(0.86±0.02)×10^-3 mm^2/s].Compared with mean and minimum ADC values,MTR asym had the best diagnostic efficacy in the diagnosis of cervical squamous carcinoma and evaluation of its histological grading.The areas under the ROC curve were 0.865 and 0.932,respectively.When thresholds of MTR asym were 3.08%and 3.06%,the diagnostic sensitivity was 79.5%and 85.2%,and the specificity was 81.8%and 83.3%,respectively.Conclusion:Compared with DWI,APT is bet
作者
侯孟岩
孟楠
王竞
刘文玲
任继鹏
韩东明
HOU Meng-yan;MENG Nan;Wang Jing(Department of Magnetic Resonance,the First Affiliated Hospital of Xinxiang Medical University,Henan 453100,China)
出处
《放射学实践》
CSCD
北大核心
2021年第1期98-102,共5页
Radiologic Practice
基金
河南省医学科技攻关计划(2018020349)
河南省医学科技攻关计划(2018020357)。
关键词
宫颈癌
磁共振成像
酰胺质子转移成像
扩散加权成像
Cervical squamous cell carcinoma
Magnetic resonance imaging
Amide proton transfer imaging
Diffusion weighted imaging
