扩散峰度成像在评估宫颈癌病理学特征及临床分期中的价值  

The value of DKI in evaluating pathological features and clinical staging of cervical cancer

作　　者：刘洁[1] 李淑健[1] 刘静静[1] 曹勤琛 高雪梅[1] LIU Jie;LI Shu-jian;LIU Jing-jing;CAO Qin-chen;GAO Xue-mei(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《中国临床医学影像杂志》2023年第2期136-140,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨扩散峰度成像(DKI)参数在宫颈癌病理类型、分化程度及临床分期中的价值。方法:回顾性分析104例宫颈癌患者的临床及影像学资料,104例患者均行常规MRI、DWI及DKI检查,测量定量参数平均扩散系数(MD)、平均扩散峰度(MK)及表观扩散系数(ADC)值。对比测量DKI参数在不同病理类型、分化程度及临床分期之间的差别,绘制ROC曲线,评价诊断效能。结果:宫颈鳞癌与腺癌间的MK、ADC值差异有统计学意义(P均<0.05);宫颈鳞癌低分化组MD、ADC值显著低于中高分化组(P均<0.05),而MK值显著高于中高分化组(P均<0.05);宫颈癌高分期组MD、ADC值显著低于低分期组,而MK值显著高于低分期组(P均<0.05)。MK、ADC值鉴别宫颈鳞癌和腺癌的曲线下面积分别为0.809、0.753;MK、MD值和ADC值在鉴别低分化与中高分化宫颈鳞癌的曲线下面积分别为0.909、0.869、0.705;MK、MD值和ADC值在鉴别低分期组与高分期组宫颈癌的曲线下面积分别为0.748、0.717、0.696。结论:DKI在评估宫颈癌临床分期、病理分型及分化程度中具有一定的应用价值,且诊断效能优于DWI。Objective: To explore the value of diffusion kurtosis imaging(DKI) parameters in evaluating the pathological type, differentiation and clinical stage of cervical cancer. Methods: The clinical and imaging data of 104 patients with cervical cancer were analyzed retrospectively. 104 patients underwent routine MRI, DWI and DKI examinations, and the quantita-tive parameters mean diffusion coefficient(MD), mean diffusion kurtosis(MK) and apparent diffusion coefficient(ADC) values were obtained. The DKI parameters were compared between different pathological types, degrees of differentiation and clinical stages.ROC curve was constructed to evaluate the diagnostic performances. Results: The differences of MK and ADC values between cervical squamous cell carcinoma and adenocarcinoma were statistically significant(all P<0.05). The MD and ADC values of the poorly differentiated group were lower than those of well/moderately differentiated group, while the MK values were higher than those of well/moderately differentiated group(all P<0.05). The MD and ADC values of the advanced-stage group were lower than those of the early-stage group, while the MK values were higher than those of the early-stage group(all P<0.05). The AUC of MK and ADC values for differentiating cervical squamous cell carcinoma and adenocarcinoma were 0.809 and 0.753,respectively. The AUC of MK, MD and ADC for distinguishing the differentiation of squamous cell carcinoma were 0.909,0.869 and 0.705, respectively. The AUC of MK, MD and ADC for distinguishing the clinical stage were 0.748, 0.717 and 0.696, respectively. Conclusion: DKI has certain application value in evaluating the clinical stage, pathological classification and differentiation of cervical cancer, and the diagnostic efficiency is better than DWI.

关 键 词：宫颈肿瘤 磁共振成像 

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