双指数模型DWI对宫颈癌分期及分级诊断的价值  

The value of bi-ponential model DWI in diagnosis of different stages,pathological types and subtypes of cervical cancer

作　　者：李君[1] 吴献华[2] 冯峰[1] 李洪江[1] 夏淦林[1] LI Jun;WU Xian-hut;FENG Fen;LI Hong-jiang;XIA Gan-lin(Department of Radiology,Nantong Tumor Hospital,Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu 226361,China;Nantong University Hospital,Nantong Jiangsu 226001,China)

机构地区：[1]南通市肿瘤医院南通大学附属肿瘤医院放射科,江苏南通226361 [2]南通大学附属医院,江苏南通226001

出　　处：《中国临床医学影像杂志》2018年第12期876-880,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨双指数模型DWI在宫颈癌分期、分级诊断中的应用价值。方法:对经手术病理证实的65例宫颈癌患者的临床影像学资料进行回顾分析,就表观扩散系数(ADC)、慢速表观扩散系数(ADC_(slow))、快速表观扩散系数(ADC_(fast))、快速扩散成分所占比(F_(fast))等单指数模型及双指数模型DWI参数在宫颈癌分期、分级中的差异进行比较。结果:65例宫颈癌中,Ⅱa期以上出现宫旁浸润患者的ADC_(slow)及ADC均小于Ⅱa期及以下无宫旁浸润患者(包括Ⅱa期),差异具有统计学意义(P<0.05)。ADC_(fast)及F_(fast)均高于非浸润组,差异无统计学意义(P>0.05)。宫颈高分化鳞癌或腺癌的ADC_(slow)及ADC均高于中、低分化鳞癌或腺癌,差异均具有统计学意义(P<0.05)。而各种级别宫颈鳞癌或腺癌的ADC_(fast)、F_(fast)均无明显差异。ROC曲线分析显示ADC_(slow)在宫颈癌分期、分级诊断中效能最高。结论:ADC_(slow)有助于评估宫颈癌的分期与分级。Objective: To investigate the value of bi-exponential model of intravoxel incoherent motion (IVIM) in diagnosisof different stages, pathological types and subtypes of cervical cancer. Methods: Sixty-five patients with pathological diagnosisof cervical cancer were collected. Apparent diffusion coefficient(ADC), slow apparent diffusion coefficient(ADCslow), fast apparentdiffusion coefficient(ADCfast) and fraction of ADCfast(Ffast) were recorded using mono-exponential signal decay model and bi-exponential signal decay model, which were then compared statistically between different stages, pathological types and subtypes.Results: In cervical cancer group, ADCslow of infiltration group was lower than non infiltration group, with statistically significant difference (P<0.05). ADCfast and Ffast of infiltration group were higher than non infiltration group, and the difference werenot statistically significant (P>0.05). ADCslow of squamous cell carcinoma was lower than adenocarcinoma cell carcinoma. ADCfastand Ffast of squamous cell carcinoma were higher than adenocarcinoma cell carcinoma, and the difference was statistically significant (P<0.05). ADCslow of cases of high differentiation was higher than cases of middle^low differentiation, with statisticallysignificant difference (P<0.05), while ADCfast and Ffast were not statistically significant (P>0.05). Receiver operating characteristiccurve analysis showed that ADCslow was the most effective in diagnosis cervical cancer of different pathological types and subtypes. Conclusion: ADCslow has a high value in diagnostic cervical cancer of different stages and subtypes.

关 键 词：宫颈肿瘤 磁共振成像 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]