标准化ADC评估宫颈癌的组织学类型及分化程度  

Value of Normalized Apparent Diffusion Coefficient in Evaluating Histological Type and Pathological Grade of Cervical Cancer

作　　者：杨蔚 强金伟 田海萍[3] 陈兵 王爱军 

机构地区：[1]宁夏医科大学总医院肿瘤医院放射科 [2]复旦大学附属金山医院影像科 [3]宁夏医科大学总医院病理科

出　　处：《中国医学计算机成像杂志》2017年第6期521-525,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金(No.81471628);上海市卫生系统先进适宜技术推广项目(No.2013SY075);上海市医学重点建设专科项目(No.ZK2015A05)~~

摘　　要：目的:探讨标准化ADC(nADC)在鉴别宫颈癌组织学类型及病理分级的价值。方法:65例经病理确诊的宫颈癌患者治疗前行常规磁共振成像(MRI)和扩散加权成像(DWI),获取肿瘤ADC值。选取患者尿液和臀大肌作为参照物,计算nADC(肿瘤ADC值/参照物ADC值)。结果:宫颈鳞癌组的ADC值、nADC(尿液)、nADC(臀大肌)明显低于腺癌组,差异具有统计学意义(均P<0.001)。ADC值、nADC(尿液)、nADC(臀大肌)和细胞密度在宫颈鳞癌不同分化组中有统计学差异(P分别为<0.001,<0.001,<0.001和0.004)。在鉴别宫颈鳞癌与腺癌、鳞癌的分化程度时,nADC(臀大肌)的诊断效能最高。nADC(臀大肌)与细胞密度的相关性最好,相关系数r为-0.785。结论:nADC能够鉴别宫颈癌的组织学类型和分化程度,并且优于肿瘤ADC值。Purpose： To investigate the diagnostic performance of normalized apparent diffusion coefficient （nADC） in evaluating histological type and pathological grade of cervical cancer. Methods： Sixty-five patients with histological confirmed cervical squamous cell carcinoma （SCC） and cervical adenocarcinoma （AC） underwent conventional magnetic resonance imaging （MRI） and diffusion-weighted imaging （DWI） on a 3.0-T MRI system. ADC value of tumor was measured and that of urine in the reference to calculate nADC of cervical cancer. ADC value, bladder and gluteus maximus muscles were used as a nADC（urine） and nADC（gluteus maximus muscles） of the tumor were compared between SCC and AC and among three different pathological grades of SCC, and were correlated with tumor cellular density. Results： ADC value, nADC（urine） and nADC（gluteus maximus muscles） of SCC were significantly lower than those of AC （all P〈0.001）. ADC value, nADC（urine）, nADC（gluteus maximus muscles） and tumor cellular density were with significan difference among the different pathological grades of SCC （P〈0.001, 〈0.001, 〈0.001 and 0.004, respectively）. Receiver operating characteristic （ROC） curve analysis revealed that nADC（gluteus maximus muscles） exhibited the most effective diagnostic performance in differentiating SCC from AC and in prediction of pathological grade of ACC. ADC value, nADC（urine） and nADC（gluteus maximus muscles） were correlated negatively with the cellular density （r=-0.705, -0.449 and -0.785, respectively, all P〈0.001）. nADC（gluteus maximus muscles ） had the most significant correlation with tumor cellular density. Conclusion： The normalized ADC has a potential ability to indicate the histological type of cervical cancer and evaluate the pathological grade of tumor, nADC using the gluteus maximus as a reference has the highest diagnostic performance and the best correlation with tumor cellular density.

关 键 词：宫颈肿瘤 扩散加权成像 表观扩散系数 细胞密度 病理分级 

分 类 号：R445.2[医药卫生—影像医学与核医学]