动态增强磁共振对宫颈良恶性病变的鉴别价值  

The Value of Dynamic Contrast Enhanced MRI to Differentiate Malignant and Benign / Normal Cervical Tissues

作　　者：邝菲[1,2] 颜志平[1,2] 冯浩[1,2] 

机构地区：[1]解放军第174医院医学影像科 [2]厦门大学附属成功医院,361003

出　　处：《临床放射学杂志》2015年第10期1611-1615,共5页Journal of Clinical Radiology

基　　金：2014年福建省自然科学基金青年创新项目(编号:2014D014);南京军区医学科技创新课题面上项目(14MS082)

摘　　要：目的探讨3.0 T动态增强磁共振成像(DCE-MRI)对宫颈良恶性病变的鉴别价值。方法对拟诊或排除子宫颈病变的241名女性就诊者行盆腔常规及DCE-MRI扫描,根据最终病理诊断结果分为宫颈癌(n=156)、宫颈肌瘤(n=35)和正常(n=50)3组。分析3组的时间-信号强度曲线(TIC)并计算动态增强半定量参数。结果注射对比剂后30 s的强化率,宫颈癌组(49.45±12.34)%高于宫颈肌瘤(16.21±5.13)%及正常组(21.87±7.35)%(F=7.12,P=0.001);120 s的强化率,正常组(158.26±39.43)%高于宫颈癌(124.08±37.83)%及宫颈肌瘤组(115.93±36.40)%(F=10.693,P=0.009);240 s的强化率,宫颈癌组(108.99±36.43)%明显低于宫颈肌瘤(140.87±22.18)%及正常组(174.71±44.16)%,正常组最高,宫颈肌瘤居中,3组的强化率对比在此期最明显(F=17.29,P=0.008);宫颈癌的达峰时间最短[(109.17±49.40)s],正常组居中[(168.21±40.84)s],宫颈肌瘤最长[(220.17±47.96)s](F=15.353,P=0.0001);注射对比剂后15 s的强化率、60 s的强化率及最大强化率在各组之间无明显差异。结论利用3.0 T动态增强磁共振成像可以有效鉴别宫颈良恶性病变,且以增强晚期对比最明显。Objective To evaluate the value of dynamic contrast-enhanced MRI（ DCE MRI） to differentiate cervical cancer from benign / normal cervical tissues. Methods A cohort of 156 cervical cancer patients,35 cervical leiomyoma patients and 50 control subjects consecutively underwent routine and DCE MRI scanning,evaluate the time signal intensity curve（ TIC） and the semi-quantitative parameters. Results The SI30s%（ signal intensity ratio for 30s） of cervical cancer was higher than cervical leiomyoma and normal cervix; the SI120s% of normal cervix was higher than cervical cancer and cervical leiomyoma; the SI240s% of cervical cancer was significantly lower than cervical leiomyoma and normal cervix,and normal cervix was the highest for SI240s%,the enhancement ratio of the three groups was significant different in this phase; the TTP（ time to peak） was shortest for cervical cancer and longest for cervical leiomyoma; there were no statistical differences in the three groups for SI15s%,SI60s% and SImax%（ the maximum enhancement ratio）. Conclusion DCE MRI at 3T was reliable in differentiating cervical cancer from benign / normal cervical tissues,and differences were significant among the three groups in the late contrast enhanced phase.

关 键 词：磁共振成像 动态增强 宫颈癌 宫颈肌瘤 半定量参数 

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