Diagnostic value of DWI combined with dynamic contrast-enhanced scan of cervical cancer staging弥散加权成像结合动态增强扫描在宫颈癌分期中的诊断价值  

Diagnostic value of DWI combined with dynamic contrast-enhanced scan of cervical cancer staging

作　　者：纪昌焕[1] 黄健威[2] 杨海南[1] 陈绵荣 

机构地区：[1]广州医科大学附属第四医院放射科,广东广州511447 [2]广州医科大学附属第三医院放射科,广东广州510150

出　　处：《中国医药导报》2015年第25期124-128,共5页China Medical Herald

基　　金：广东省科技计划项目(20110316)

摘　　要：目的探讨磁共振弥散加权成像（DWI）结合动态增强扫描在子宫颈癌分期中的诊断价值。方法回顾性分析2013年11月-2014年8月广州医科大学附属第四医院56例经病理证实的宫颈癌患者的DWI及动态增强扫描结果。测量病灶表观扩散系数（ADC）值判断浸润范围，并与手术病理结果进行比较。结果宫颈癌在DWI图像上表现为高信号，ADC值降低，平均ADC值为（0．92±0．16）×10^-3mm^2／s。动态增强扫描早期病灶明显快速强化，延迟期病灶中心呈低信号，病灶边缘呈稍高信号，与邻近正常宫颈组织信号明显不同，形成对比。DWI结合动态增强扫描对宫颈癌FIGO分期（2009）总准确性为93．75％，高于常规MRI分期总准确性（81．25％），对宫旁浸润评估的准确性为100．00％。结论，DWI结合动态增强扫描磁共振检查能提高宫颈癌侵犯程度评价的准确性，对宫颈癌的诊断、临床分期及制订正确的治疗方案具有重要意义。Objective To evaluate the diagnostic value of DWI combined with dynamic contrast-enhanced scans in the staging of cervical cancer. Methods DWI and dynamic contrast-enhanced scanning performance of 56 cervical cancer patients from November 2013 to August 2014 in the Fourth Affiliated Hospital of Guangzhou Medical University confirmed with pathology were retrospective analyzed, the lesion scope of infiltration was evaluated by measurement of ADC values, and the results were compared with surgical pathology. Results Cervical cancer on DWI images showed high signal, ADC values reduced significantly, the ADC value was （0.92±0.16）×10^-3mm^2/s. In dynamic contrast-en- hanced scans , lesions significantly and fast enhanced in early stage, lesion center showed low signal lesion edges slightly higher signal in delay stage, which were significantly different with the adjacent normal cervical tissue signal and form contrast. The total accuracy of DWI combined with dynamic contrast-enhanced scan of cervical cancer FIGO stage （2009） was 93.75%, higher than the conventional MRI staging （81.25%）, the accuracy of assessing parametrial invasion was 100.00%. Conclusion DWI combined with dynamic contrast-enhanced MRI scans can improve the accuracy of degree evaluation of cervical cancer invasion, and play an important role in diagnosis, clinical staging of cervical cancer and make the fight treatment.

关 键 词：磁共振成像 扩散加权成像 动态增强 宫颈癌 肿瘤分期 

分 类 号：R737.33[医药卫生—肿瘤]