体素内不相干运动扩散加权成像参数值与子宫颈鳞癌病理分化相关性初步研究  

Correlation Study between Parameters of Intravoxel Incoherent Motion Diffusion-weighted Imaging and Pathologic Differentiation of Cervical Squamous Carcinoma

作　　者：李乃玉[1] 王传彬[1] 高飞[1] 韦超[1] 李信响 方昕[1] 周辉 董江宁[1] LI Nai-yu;WANG Chuan-bin;GAO Fei;WEI Chao;LI Xin-xiang;FANG Xin;ZHOU Hui;DONG Jiang-ning(Department of Radiology, Anhui Provincial Cancer Hospital, First AffiliatedHospital of University of Science and Technology of China;Department of Radiology, Fengyang County People's Hospital)

机构地区：[1]安徽省肿瘤医院、中国科学技术大学附属第一医院西区 [2]安徽省滁州市凤阳县人民医院

出　　处：《中国医学计算机成像杂志》2018年第6期515-520,共6页Chinese Computed Medical Imaging

基　　金：安徽省重点研究和开发计划项目(No.1814h08020294)

摘　　要：目的:探讨子宫颈鳞癌3.0TMRI体素内不相干运动扩散加权成像(IVIM-DWI)参数值与病理分化程度的相关性。方法:收集2015年11月～2017年11月确诊为子宫颈鳞癌的患者,纳入研究组共计73例,年龄27～73岁,其中高分化组7例、中分化组23例,低分化组43例。治疗前均接受常规MR及IVIMDWI检查(b=0、20、40、60、100、200、400、800、1000、2000s/mm^2)。应用GEADW4.5后处理工作站Functool软件分别测量三组中D、D*及f值,并对不同分化程度宫颈鳞癌与IVIM-DWI三个参数之间差别进行统计学分析。结果:低分化组D值(0.50±0.08)×10-3mm^2/s、D*值(8.55±1.39)×10-3mm^2/s、f值(37.87±13.12)%;中分化组D值(0.63±0.11)×10-3mm^2/s、D*值(18.50±2.71)×10-3mm^2/s、f值(23.24±2.75)%;高分化组D值(0.80±0.07)×1010-3mm^2/s、D*值(41.25±15.58)×10-3mm^2/s、f值(13.81±2.26)%;低、中、高分化各组之间D、D*及f值差异均有统计学意义(P<0.05)。D值及D*值与子宫颈癌病理分化呈中度及高度正相关,f值呈中度负相关。结论:体素内不相干运动扩散加权成像能够无创性的评估子宫颈鳞癌分化程度及血流灌注,有助于临床早期评估子宫颈癌放化疗疗效,从而帮助临床制定合理的治疗方案。Purpose: To explore the correlation between parameters of intravoxel incoherent motion diffusionweighted imaging and pathologic differentiation of cervical squamous carcinoma. Methods: Seventy-three patients (average age 50.0±9.06 years, age range 27-73 years) with cervical squamous carcinoma between November 2015 and November 2017 were enrolled in this prospective/retrospective study. All the patients with cervical squamous carcinoma proved by pathology results (7 cases were well-differentiated, 23 cases moderately-differentiated, and 43 cases poor-differentiated) were undergone intravoxel incoherent motion diffusion-weighted imaging (IVIMDWI) (b=0, 20, 40, 60, 100, 200, 400, 800, 1000, and 2000 s/mm^2) and conventional magnetic resonance imaging examination. D value, D^* value and f value from IVIM-DWI were used for statistical analysis. Results: The mean ADC value and percentage of three groups were as following: Poor-differentiated groups (D value (0.50±0.08)×10^- 3mm^2/s, D^* value (8.55±1.39)×10^-3mm^2/s, f value (37.87±13.12)%), moderately-differentiated groups (D value (0.63±0.11)×10^-3mm^2/s, D^* value (18.50±2.71)×10^-3mm^2/s, f value (23.24±2.75)%), and well-differentiated groups (D value (0.80±0.07)×10^-3mm^2/s, D^* value (41.25±15.58)×10^-3mm^2/s, f value (13.81±2.26)%). There were significant inter-groups differences of the D value, D^* value, and f value (P<0.05). Compared with both D value (r=0.739) and D^* value (r = 0.870), f value (r=-0.674) showed a negative correlation with pathologic differentiation for cervical squamous carcinoma. Conclusion: The semi-quantitative parameters from of IVIM-DWI can represent the grades of histological differentiation and allowing a promising new method of non-invasively assessing the pathological grade and perfusion of the tumor, which is helpful to evaluate the efficacy of radiotherapy for cervical cancer, thus help clinical doctor to make treatment protocols.

关 键 词：体素内不相干运动 扩散加权成像 宫颈癌 病理分化 

分 类 号：R445.2[医药卫生—影像医学与核医学]