摘要
目的研究多b值弥散加权成像(DWI)对宫颈癌病理学特征及术前分期的诊断价值。方法选取经病理确诊的宫颈癌患者87例为研究对象,均行1. 5T MR常规序列及多b值DWI扫描,记录宫颈癌区、非癌区(结合带、肌层)的多b值DWI参数值[双指数衰减模型计算慢速表观扩散系数(ADC_(slow))、快速表观扩散系数(ADCfast)、快速弥散所占容积分数(F_(fast))],并分析各参数与宫颈癌病理学特征的关系及对术前分期的诊断价值。结果宫颈癌区ADC_(slow)、ADC_(fast)、F_(fast)低于结合带非癌区、肌层非癌区(P <0. 05),结合带、肌层非癌区上述指标对比差异无统计学意义(P>0. 05)。鳞癌ADC_(slow)低于腺癌,而ADC_(fast)、F_(fast)高于腺癌(P <0. 05);随分化程度增加,ADC_(slow)增加(P <0. 05),而ADC_(fast)、F_(fast)无明显变化(P>0. 05);不同肿瘤直径、有无淋巴结转移患者多b值DWI参数值比较差异无统计学意义(P> 0. 05)。不同术前分期患者ADC_(slow)比较差异有统计学意义(P <0. 05)。结论多b值DWI与宫颈癌患者病理类型、分化程度等病理学特征存在一定关系,同时可用于指导术前分期,值得在临床推广应用。
Objective To study the value of diffusion-weighted imaging(DWI)with multiple b values in the diagnosis of pathological features and preoperative stage of cervical cancer.Methods 87 patients with cervical cancer diagnosed by pathology in the hospital from January 2015 to February 2018 were selected as the subjects.1.5 T MR routine sequence and DWI scan with multiple b values were performed.Parameters of DWI with multiple b values[slow apparent diffusion coefficient(ADCslow),fast apparent diffusion coefficient(ADCfast)and fraction of fast ADC(Ffast)measured by the bi-exponential model]of cervical cancer and non-cancer area(junctional zone,muscular layer)were recorded.The relationship between the parameters and pathological features of cervical cancer,and the value in the diagnosis of preoperative stage were analyzed.Results The ADCslow,ADCfast and Ffast of cervical cancer area were lower than those of non-cancer areas of junctional zone or muscle layer(P<0.05),without significant difference in the above indexes between non-cancer areas of junctional zone and muscle layer(P>0.05).The ADCslowof squamous carcinoma was lower than that of adenocarcinoma,while ADCfast and Ffast were higher than those of adenocarcinoma.With the increase of differentiation degree,ADCslow increased(P<0.05),while there was no obvious change of ADCfastor Ffast(P>0.05).There was no significant difference in parameters of DWI with multiple b values between patients with different tumor diameters or patients with and without lymph node metastasis(P>0.05).There were significant differences of ADCslow between patients with different preoperative stages(P<0.05).Conclusion There is a certain relationship between DWI with multiple b values and pathological features such as pathological types and differentiation degree of cervical cancer.It can also be used to guide preoperative staging.
作者
罗锐
李广明
许建华
LUO Rui;LI Guangming;XU Jianhua(Affiliated Hospital of Hubei College of Arts and Sciences,Xiangyang Central Hospital of Hubei,Xiangyang,441021)
出处
《实用癌症杂志》
2019年第4期564-567,共4页
The Practical Journal of Cancer
基金
湖北省自然科学基金项目(编号:2017CBD0264)
关键词
多b值弥散加权成像
宫颈癌
病理学特征
术前分期
诊断价值
Diffusion-weighted imaging with multiple b values
Cervical cancer
Pathological features
Preoperative staging
Diagnostic value
