MR体素内不相干运动成像评价宫颈癌组织学特征的初步研究  

Preliminary study of Intravoxel Incoherent Motion MR Imaging in Assessing Histological Characters of Cervical Cancer

作　　者：叶晓华[1] 周诚[1] 王宏[1] 张晨[1] 陈敏[1] 

机构地区：[1]北京大学第五临床医学院,北京医院放射科,100730

出　　处：《临床放射学杂志》2016年第7期1048-1052,共5页Journal of Clinical Radiology

摘　　要：目的探讨MR体素内不相干运动(IVIM)成像评价宫颈癌组织学特征的可行性。方法搜集24例宫颈癌患者(宫颈癌组)和24例因盆腔其他病变检查而宫颈正常者(宫颈正常组)的MRI资料。所有患者均行MR常规序列及IVIM序列扫描,测量宫颈癌组和宫颈正常组的标准表观扩散系数(ADC)、慢表观扩散系数(D)、快表观扩散系数(D*)和f值。比较宫颈癌与正常宫颈、宫颈癌不同病理类型以及不同病理分级上述各参数值的差异,采用受试者工作特征(ROC)曲线下面积评价各参数值的诊断效能。结果宫颈癌组的标准ADC值、D值、f值均低于宫颈正常组,差异有统计学意义(P=0.000、0.000、0.001),ROC曲线下面积分别为0.872、0.848和0.762。宫颈鳞癌组的标准ADC值、D值、f值均低于宫颈腺癌组,D*值高于宫颈腺癌组,差异有统计学意义(P=0.000、0.037、0.004、0.000),ROC曲线下面积分别为0.938、0.975、0.900和0.938。宫颈鳞癌高分化、中分化和低分化三组间标准ADC值、D值、D*值及f值差异无统计学意义(P=0.500、0.753、0.341、0.266)。结论 IVIM成像能定量反映宫颈癌的组织学特征,具有临床应用价值。Objective To investigate the feasibility of intravoxel incoherent motion（ IVIM） MR imaging in assessing histological characters of cervical cancer. Methods MR imaging data of 24 patientswith cervical cancer and 24 patients with normal cervix were analyzed. All patients underwent conventional MR sequences and IVIM sequence. The parameters including standard ADC,D,D＊ and f were measured in all patients. The data were compared between cervical cancer and normal cervix groups,different pathological type groups and different pathological grading groups. Diagnostic efficacy of the above parameters were evaluated by using the area under ROC curve. Results The values of standard ADC,D and f in cervical cancer group were statistically lower than those in normal cervix group（ P= 0. 000,0. 000,0. 001）,the areas under ROC curve were 0. 872,0. 848 and 0. 762,respectively. Compared with the adenocarcinoma of cervix group,the cervical squamous carcinoma group had statistically lower standard ADC,D,f and statistically higher D＊（ P = 0. 000,0. 037,0. 004,0. 000）,the areas under ROC curve were 0. 938,0. 975,0. 900 and0. 938,respectively. There were no statistically difference in four parameters among the three different pathological grading groups（ P = 0. 500,0. 753,0. 341,0. 266）. Conclusion VIM MR imaging can quantitatively reflected the histological characters of cervical cancer and is valuable in clinical application.

关 键 词：宫颈癌 磁共振成像 扩散加权成像 表观扩散系数 

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]