3.0 T MR扩散加权成像评估宫颈鳞癌病理分级的应用价值  

The Clinical Application of 3.0 T MR Diffusion Weighted Imaging in the Evaluation of Different Pathological Grade of Cervical Squamous Cell Carcinoma

作　　者：牟东景 樊斌[1] MU Dongjing;FAN Bin(Department of Medical Imaging,Central Hospital of Huanggang,Huanggang,Hubei Province 438000,P.R.Chin)

机构地区：[1]湖北省黄冈市中心医院医学影像科

出　　处：《临床放射学杂志》2018年第7期1159-1162,共4页Journal of Clinical Radiology

摘　　要：目的探讨3.0 T MR扩散加权成像（DWI）定量参数表现扩散系数（ADC）值评估宫颈鳞癌病理分级的价值。方法回顾性分析77例经病理证实为宫颈鳞癌患者的DWI图像,按照病理分级分为高分化组（14例）,中分化组（37例）,低分化组（26例）,分别测量各组病灶ADC值,对三组数据进行单因素方差分析（one-way ANOVA）,并进行组间两两比较。采用Spearman相关分析检验宫颈鳞癌ADC值与病理分级的相关性,进一步绘制ROC曲线确定诊断低分化宫颈鳞癌的最佳临界点。结果高分化组、中分化组及低分化组宫颈鳞癌的ADC值分别为（0.98±0.12）×10^-3mm^2/s、（0.87±0.10）×10^-3mm^2/s、（0.75±0.08）×10^-3mm^2/s,差异具有统计学意义（F=26.95,P〈0.05）。宫颈鳞癌ADC值与病理分级存在负相关（r=-0.66,P〈0.05）。ROC曲线分析显示ADC值用于诊断低分化宫颈鳞癌的最佳临界点为0.78×10^-3mm^2/s,其敏感性为84.6%,特异性为86.3%,准确性为85.7%。结论3.0 T MR DWI定量参数ADC值在宫颈鳞癌术前病理分级评估中具有较高的应用价值,有助于预测宫颈鳞癌的恶性程度,可为治疗方案的选择及预后的评价提供更多的信息。Objective To investigate the clinical application of 3. 0 T MR diffusion weighted imaging（ DWI） in the evaluation of different pathological grades of cervical squamous cell carcinoma. Methods A retrospective analysis of 3. 0 T MR DWI in 77 patients with pathologically diagnosed cervical squamous cell carcinoma. They were divided into three groups based on grade of differentiation： well differentiated（ 14 patients）,moderately differentiated（ 37 patients） and poorly differentiated group（ 26 patients）. The ADC values were measured separately,The ADC values of the three groups were analyzed by one-way ANOVA method,and results were compared between each other among the groups. Spearman correlative analysis test was used to evaluate correlation between the ADC values and pathological grade of cervical squamous cell carcinoma. The ROC curve was drawn,and the cutoff value for poorly differentiated cervical squamous cell carcinoma was determined. Results ADC values of the well,moderately and poorly differentiated cervical squamous cell carcinoma were（ 0. 98 ± 0. 12） × 10^-3mm^2/s、（ 0. 87 ± 0. 10） × 10^-3mm^2/s、（ 0. 75 ± 0. 08） × 10^-3mm^2/s respectively,the difference was statistically significant（ F = 26. 95,P〈0. 05）. There was a negative correlation between ADC values and the pathological grade（ r =-0. 66,P〈0. 05）. ROC curve analysis showed that the ADC value for the best critical point of diagnosis for poorly differentiated cervical squamous cell carcinoma was 0. 78 × 10^-3mm^2/s. The sensitivity was 84. 6%,specificity was86. 3%,accuracy was 85. 7%. Conclusion The value of 3. 0 T MR DWI ADC has high value in the evaluation of different pathological grades of cervical squamous cell carcinoma,which is helpful in predicting the malignancy of the lesion and providing more information for treatment and prognostic evaluation.

关 键 词：宫颈鳞癌 病理分级 扩散加权成像 表现扩散系数 磁共振成像 

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]