扩散加权成像对宫颈癌分期与疗效预测的价值  

The value of diffusion-weighted MRI in the assessment of cervical cancer

作　　者：贺中云 方向军[2] 黄亮[2] 何卫红[2] 郭岗[3] 田强 

机构地区：[1]湖南省株洲市三三一医院放射科,株洲412002 [2]南华大学附属第二医院放射科,衡阳421001 [3]福建省厦门市第二医院放射科,厦门361021

出　　处：《磁共振成像》2014年第5期362-366,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：湖南省科技厅基金资助项目(编号:2011SK3188)

摘　　要：目的探讨扩散加权成像(DWI)表现及表观扩散系数(ADC)值在宫颈癌分期、放化疗短期疗效预测中的应用价值。材料与方法对68例治疗前的宫颈癌患者,行常规MRI及DWI检查,将常规MRI分期、常规MRI结合DWI分期与病理分期进行对照,比较两种方法对宫颈癌分期准确性的差异。测量宫颈癌各期的ADC值,分析ADC值与宫颈癌分期的相关性。对38例行放化疗的宫颈癌患者进行追踪复查,将疗效分为完全缓解组(CR)组和部分缓解组(PR)组,比较两组患者放化疗前的ADC值的差异。结果 (1)常规MRI序列漏诊1例Ib期,常规MRI结合DWI检出全部病例,常规MRI对IIa期分期符合率85%,而与DWI联合应用符合率达95%,但两种方法无统计学意义。(2)对宫颈癌各期的ADC值进行比较,P>0.05,无统计学意义,宫颈癌的分期与ADC值无相关性。(3)38例行放化疗的宫颈癌患者,25例CR组治疗前ADC均值1.02×10-3 mm2/s,13例PR组治疗前ADC均值1.14×10-3 mm2/s,采用t检验法比较两组ADC值,P<0.05,具有统计学意义,CR组ADC值低于PR组。结论常规MRI序列联合DWI对于宫颈癌的检出及分期更准确,ADC值对放化疗短期疗效有一定的预测价值。Objective：To investigate the potential value of diffusion weighted imaging （DWI） and the apparent diffusion coefifcient （ADC） for staging and predicting shortterm treatment response to nonsurgical therapy （chemo-and/or radiotherapy） of patients with cervical cancer. Materials and Methods： Sixty-eight patients with cervical cancer underwent DWI in addition to routine MR imaging at MRI before therapy. The staging accuracy by routine MRI sequences and routine MRI combined with DWI was compared with surgical specimens as the reference standard. All ADCs were calculated from b=0, 800 s/mm2 and the correlation between ADC and histologic stages of cervical cancer was evaluated. Thirty-eight patients were followed up after nonsurgical therapy and divided into complete response （CR） group and partial response （PR） group according to the results of follow-up. Difference of ADC between the two groups was compared with student’s t test. Results：（1） One stage Ib case of missed diagnosis occurred as routine MRI adopted and all cases of cervical cancer were found out by routine MRI combined with DWI. The accuracy of routine MRI for staging IIa was 85%and the combined use of routine MRI and DWI made accuracy 95%, yet there was not statistically signiifcance between the two methods. （2） ADC value of each stage of cervical cancer was compared and no statistically significance was found （P〉0.05）. There was no correlation between ADC values and all stages. （3） The mean pre-therapy ADC value of CR group （n=25） and PR group （n=13） was 1.02±10-3 mm2/s and 1.14＆#215;10-3 mm2/s respectively. There was a statistically signiifcant difference between the two groups （P〈0.05）. Conclusions：Routine MRI combined with DWI has high accuracy for detecting and staging of cervical cancer. ADC could predict short-term treatment response to nonsurgical therapy for patients with cervical cancer.

关 键 词：宫颈肿瘤 磁共振成像 弥散 

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]