非增强磁共振鉴别宫颈良恶性病变的价值  

The value of non-contrast MRI to differentiate malignant and benign cervical lesions

作　　者：邝菲[1] 颜志平[1] 王健[1] 饶志远[1] 冯浩[1] 

机构地区：[1]解放军第一七四医院医学影像科,福建厦门361003

出　　处：《实用放射学杂志》2013年第12期1983-1987,共5页Journal of Practical Radiology

摘　　要：目的评估非增强磁共振（常规MRI及DWI）鉴别宫颈良恶性病变的价值。方法共98例宫颈癌患者，26例宫颈肌瘤忠肯及32例宫颈重度上皮内瘤变（CINⅢ）患者及45例健康对照者行3．0TMRI扫描。2名放射医师独立分析所有受检者的常规MRI序列（T1WI、T2WI），常规MRI联合DWI序列搜常规MRI联合动态增强MRI序列（DCE-MRI），并进行定性诊断,1名放射医师测量所有受检者的ADC值。结果常规MRI联合DWI序列及常规MRI联合DCE-MRI序列有极好的评判者间一致性；对于鉴别宫预良恶性病变，常规MRI联合DWI序列可抉得极高的诊断准确性（0．98）并明显优于常规MRI序列（P〈0．001）,且与常规MRI联合DCE—MRI序列相比无明显差异。宫颈癌的ADC值明碌低于宫颈肌瘤、CINⅢ及正常宫颈组织。结论3．0T非增强磁共振（常规MRI联合DWI序列）可准确鉴别宫颈良恶性病变,ADC值亦可有效区分宫颈良恶性病变，DWI序列应纳入常规MR女性盆腔扫描。Objective To evaluate the value of non contrast MRI （routine MRI and diffusion weighted-MRI） to differentiate cervi- cal cancer from benign/normal cervical tissues. Methods A cohort of 98 cervical cancer patients, 26 cervical leiomyoma patients, 32 patients with cervical intraepithelial neoplasia （CINⅢ） and 45 control subjects consecutively underwent pelvic MRI scanning on 3-T MR unit. Two radiologists independently evaluated MR images on routine MRI （T1WI and T2WI）, combination of routine MRI and DW imaging, and combination of routine MRI and DCE MRI （dynamic contrast-enhanced MRI）. Results Reader agreement was both excellent for combination of routine MRI and DWI and combination of routine MRI and DCE-MRI. For differentiation of cervi cal cancer from henign/normal cervical tissues, combination of routine MRI and DW imaging was significantly better than routine MRI alone （P〈0. 001） and obtained the excellent diagnostic accuracy （0.98）, the discriminatory capability was not significantly different hetween the combination of routine MRI and DW images and combination of routine MRI and DCE-MR images （P〉0.05）. The ADCs of cervical cancer were significantly lower than those of benign/normal cervical tissues at both ADC maps. Conclusion Non contrast MRI comhination （routine MRI＋ DWI） at 3T MR can provide accurate information for differentiation of cervical cancer from benign/norrnal cervical tissues. The ADC values were also reliably in differentiating cervical cancer from benign/normal cervical tissues. DWl should be included in routine MR imaging protocols for evaluation of the female pelvis.

关 键 词：磁共振成像 弥散加权成像 宫颈癌 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]