ADC值对宫颈癌的诊断价值及其与临床病理因素的关系  

The diagnostic value of ADC values of cervical cancer and the relationship with clinicopathological factors

作　　者：牛庆亮[1] 杜汉旺[1] 李芹[1] 武希庆 李明志[1] 郑召龙 

机构地区：[1]山东省潍坊市中医院影像科,山东潍坊261041

出　　处：《中国中西医结合影像学杂志》2016年第5期520-523,526,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:分析ADC值对宫颈癌的诊断价值,探讨宫颈癌ADC值与临床病理因素的关系。方法:46例宫颈癌患者术前行3.0 T MRI常规扫描及DWI检查,20例成年健康女性志愿者作为对照组行DWI。比较宫颈癌与正常宫颈全层、内膜层、结合带、肌层ADC值。分析宫颈癌ADC值与肿瘤体积、病理分级、病理类型、临床分期的关系。结果:宫颈癌ADC值为(0.924±0.110)×10^(-3)mm^2/s,低于正常宫颈全层ADC值(1.626±0.242)×10^(-3)mm^2/s、内膜层ADC值(1.590±0.311)×10^(-3)mm^2/s、结合带ADC值(1.361±0.203)×10^(-3)mm^2/s、肌层(1.911±0.305)×10^(-3)mm^2/s(均P<0.05)。肌层ADC值最高,内膜次之,结合带最低,两两比较,差异均有统计学意义(均P<0.05)。宫颈鳞癌ADC值(0.927±0.113)×10^(-3)mm^2/s与腺癌ADC值(0.856±0.093)×10^(-3)mm^2/s比较,差异无统计学意义(P>0.05)。Ⅰb~Ⅱa期宫颈癌ADC值为(0.932±0.118)×10-3 mm2/s,Ⅱb~Ⅳ期为(0.920±0.109)×10-3 mm2/s,两者差异无统计学意义(P>0.05)。宫颈癌ADC值与肿瘤体积无相关性(P>0.05),与肿瘤病理学分级呈负相关(r=-0.473,P=0.026)。低分化宫颈癌ADC值为(0.805±0.065)×10^(-3)mm^2/s,低于中/高分化组宫颈癌ADC值(0.952±0.099)×10^(-3)mm^2/s(t=-2.938,P=0.008)。结论:ADC值测量有助于鉴别宫颈癌和正常宫颈组织,宫颈癌ADC值在一定程度上可反映肿瘤分化程度。Objective：The aim of this study was to determine whether the apparent diffusion coefficient （ADC） measurements had any contribution in differentiation of normal cervix from cervical cancer ,and to analyze the relationships between the ADC value of tumor and the clinicopathological factors. Methods：Forty six patients with cervical cancer and 20 female healthy vol-unteers were included in this study. Preoperative MRI examinations were performed at a GE 3.0T MR scanner. The ADC value of tumor was compared with that of the normal cervix. We investigated whether there was a correlation between the mean ADC values and tumor volume,histologic type,pathologic grade and stage in malignant lesions. Results：Cervical cancer lesion demon-strated obviously hyperintensity on DWI images,and the mean ADC value of tumor （0.924±0.110）×10^-3 mm^2/s was statistically lower than that of cervical whole layer （1.626 ±0.242） ×10^-3 mm^2/s,endometrium （1.590 ±0.311） ×10^-3 mm^2/s,conjunctive zone （1.361±0.203）×10^-3 mm^2/s and muscular layer（1.911±0.305）×10^-3 mm^2/s （P〈0.05）. There was no significant difference between the ADC of squamous carcinoma and that of adenocarcinoma ,and between the ADC ofⅠb~Ⅱa and that of Ⅱb~Ⅳ（P〉0.05）. The mean ADC value of poorly differentiated tumors （0.805±0.065）×10^-3 mm^2/s was statistically lower than that of well/moderately differentiated tumors （0.952±0.099）×10^-3 mm^2/s （P〈0.05）. The ADC value of uterine cervical cancer correlated negatively with the grading of tumor （r=-0.473,P=0.026）. The value of cervical cancer was not correlated with tumor volume （P〉0.05）. Conclusion：ADC measurement has a potential ability to differentiate between cancer and the normal cervical tissue. The ADC value of uterine cervical cancer correlates negatively with the grading of tumor ,thus providing a new method for e-valuating the pathologic grading of tumor.

关 键 词：磁共振成像 弥散 表观弥散系数 宫颈肿瘤 病理学 临床 

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