磁共振动态增强扫描及弥散加权成像在评估早期宫颈癌淋巴血管间隙侵犯中的应用价值  

Application value of dynamic contrast enhanced-magnetic resonance imaging and diffusion-weighted imaging in evaluating lymph-vascular space invasion in early cervical cancer

作　　者：石洋洋 付娟[1] 刘浩[1] SHI Yangyang;FU Juan;LIU Hao(Department of MRI,Yulin No.2 Hospital,Yulin 719000,Shaanxi,China)

机构地区：[1]榆林市第二医院磁共振室,陕西榆林7190000

出　　处：《癌症进展》2022年第12期1293-1296,共4页Oncology Progress

摘　　要：目的探讨磁共振动态增强扫描(DCE-MRI)及弥散加权成像(DWI)在评估早期宫颈癌淋巴血管间隙侵犯(LVSI)中的应用价值。方法将80例早期宫颈癌患者根据是否出现LVSI分为观察组(合并LVSI,n=31)及对照组(未合并LVSI,n=49)。比较两组患者DCE-MRI参数、DWI参数,以病理学检查结果为金标准,分析DCEMRI及DWI对早期宫颈癌LVSI的诊断价值。结果观察组患者的血管外细胞外间隙容积比(Ve)、容量转移常数(Ktrans)、速率常数(Kep)均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者最小表观扩散系数(ADC)值明显低于对照组,差异有统计学意义(P﹤0.01)。联合诊断的准确度高于DCE-MRI或DWI单独诊断。DCE-MRI诊断宫颈癌LVSI的曲线下面积(AUC)为0.809,DWI诊断宫颈癌LVSI的AUC为0.784,二者联合诊断宫颈癌LVSI的AUC为0.921,联合诊断的AUC最大。结论早期宫颈癌合并LVSI患者的Kep、Ktrans及Ve值均升高,ADC值降低,临床上可通过结合DCE-MRI及DWI提高对早期宫颈癌合并LVSI的诊断准确度。Objective To evaluate the value of dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI)and diffusion-weighted imaging(DWI)in evaluating lymph-vascular space invasion(LVSI)of early cervical cancer.Method A total of 80 patients with early cervical cancer were divided into the observation group(n=31,with LVSI)and the control group(n=49,without LVSI)based on the presence of LVSI.The DCE-MRI parameters and DWI parameters were compared between the two groups and the diagnostic value of DCE-MRI and DWI in early cervical cancer was analyzed by using pathological results as the gold standard.Result The values of Ve,Ktrans and Kep in the observation group were significantly higher than those in the control group(P<0.05).The minimum apparent diffusion coefficient(ADC)value of the observation group was significantly lower than that of the control group(P<0.01).The accuracy of combined diagnosis was higher than that of single diagnosis.The area under the curve(AUC)of DCE-MRI in diagnosing LVSI was 0.809,the AUC of DWI was 0.784,the AUC for combined diagnosis was 0.921.Conclusion The values of Kep,Ktrans and Ve in patients with early cervical cancer complicated with LVSI are increased,while the value of ADC is decreased.The diagnostic accuracy of early cervical cancer complicated with LVSI can be improved by combining DCE-MRI and DWI.

关 键 词：磁共振动态增强扫描 弥散加权成像 早期宫颈癌 淋巴血管间隙侵犯 

分 类 号：R737.33[医药卫生—肿瘤]