多b值DWI在宫颈癌及CIN Ⅲ诊断中的应用  

Multi-b-value DWI in diagnosing of cancer and CIN Ⅲ of the cervix

作　　者：张洁[1] 张亚利 林瑞贞 杜中立[1] 陈敏[1] 吴雪丽[1] 

机构地区：[1]珠海市人民医院放射影像科,广东珠海519000 [2]榆林市绥德县辛店卫生院,陕西榆林718000 [3]珠海市人民医院妇产科,广东珠海519000

出　　处：《实用放射学杂志》2017年第5期715-719,共5页Journal of Practical Radiology

基　　金：珠海市医学科研基金资助项目（2015J034）.

摘　　要：目的 分析正常宫颈及宫颈癌、宫颈高级别上皮内瘤变（CIN Ⅲ）的多b值扩散加权成像（DWI）的特点,探讨其对宫颈癌诊断和判断病理类型的价值.方法 收集经手术或活检证实宫颈癌患者54例（腺癌15例,鳞癌36例、神经内分泌癌3例）和CIN Ⅲ 9例,行常规MR和多b值DWI扫描.对比正常宫颈组织和宫颈癌组织的多b值表观扩散系数（ADC）值.对测得的不同病理类型宫颈癌、CIN Ⅲ与正常宫颈的ADC值进行比较.结果 正常宫颈的宫颈内膜、结合带及肌层3层结构可以在不同b值的DWI上显示,各层之间的ADC值差异有统计学意义（P＜0.05）;宫颈癌的多b值ADC值与正常宫颈之间的差异有统计学意义（P＜0.05）;宫颈鳞癌、腺癌、CIN Ⅲ、神经内分泌癌的平均ADC值差异有统计学意义（P＜0.05）.结论 多b值DWI的ADC值有助于宫颈癌及CIN Ⅲ的诊断,并与宫颈癌的病理类型存在相关性.应用多b值DWI检查可以提高宫颈癌、CIN Ⅲ定性诊断的准确性.Objective To analyze the characteristics of multi-b-value diffusion weighted imaging （DWI） of the normal cervical, cervical cancer and cervical intraepithelial neoplasia（CIN Ⅲ）,and to assess the value of DWI in diagnosis and pathological staging for cervical cancer.Methods There were 54 patients with pathologically confirmed cervical cancer,including 36 squamous cell carcinoma,15 adenomatous carcinoma, and 3 neuroendocrine carcinoma.And other 9 patients with CIN Ⅲ were involved in the study.All patients underwent conventional MR scan with multi-b-value DWI sequence.The apparent diffusion coefficient （ADC） values of multi-b-value DWI were compared between normal cervical tissue and cervical cancer with its different pathology subtypes.Results The three normal structure of uterine cervix, including cervical endometrial, junctional zone and myometrium, can be clearly distinguished by different b-value DWI, with a statistical difference of ADC value （P〈0.05）.Further analysis showed that the average ADC values between normal cervix and cervical cancer had a statistical difference （P〈0.05）.The similar situation was presented among squamous cell carcinoma, adenomatous carcinoma, neuroendocrine carcinoma and CIN Ⅲ（P〈0.05）.Conclusion The ADC values of multi-b-value DWI could be helpful to diagnose cervical cancer and CIN Ⅲ,and it is correlated with the pathological type of cervical cancer.The application of multi-b-value DWI to cervical cancer and CIN Ⅲ could increase the accuracy of diagnosis.

关 键 词：宫颈癌 扩散加权成像 表观扩散系数 

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